The teaching and use of a mnemonic to improve the management of shoulder dystocia

Abstract

Aims to assess the benefits of using a mnemonic to structure the care given during episodes of shoulder dystocia, an obstetric emergency that has important sequelae for the mother and infant. A retrospective case‐notes‐based study was carried out to describe practice prior to the introduction of the mnemonic. A prospective study was undertaken to evaluate the use of a mnemonic in practice, and whether this had an effect on foetal morbidity. Prior to the introduction of the mnemonic and structured documentation, care was delivered in an unstructured and in a non‐evidence‐based manner in 35 per cent of patients; documentation was incomplete in 68 per cent of cases. There was a 5 per cent incidence of injury to the infant. Following the introduction of a mnemonic, the use of evidence‐based manoeuvres increased to 100 per cent, and care was delivered in a structured manner and there were no recorded injuries to infants. The management of shoulder dystocia has been made safer and more controlled by using a mnemonic to describe an evidence‐based pathway. It has facilitated a multi‐disciplinary team‐based approach to the management of this obstetric emergency.