Does training in obstetric emergencies improve neonatal outcome?

TJ Draycott, T Sibanda, L Owen, V Akande, C Winter, S Reading, A Whitelaw

Research output: Contribution to journalArticle (Academic Journal)peer-review

403 Citations (Scopus)


Objectives To determine whether the introduction of Obstetrics Emergency Training in line with the recommendations of the Clinical Negligence Scheme for Trusts (CNST) was associated with a reduction in perinatal asphyxia and neonatal hypoxic–ischaemic encephalopathy (HIE). Design A retrospective cohort observational study. Setting A tertiary referral maternity unit in a teaching hospital. Population Term, cephalic presenting, singleton infants born at Southmead Hospital between 1998 and 2003 were identified; those born by elective Caesarean sections were excluded. Method Five-minute Apgar scores were reviewed. Infants that developed HIE were prospectively identified throughout this period. The study compared the period ‘pre-training’ (1998–1999), with the period ‘post-training’ (2001–2003). Main outcome measures Five-minute Apgar scores and HIE. Results Infants (19,460) were included. Infants born with 5-minute Apgar scores of ≤6 decreased from 86.6 to 44.6 per 10,000 births (P <0.001) and those with HIE decreased from 27.3 to 13.6 per 10,000 births (P= 0.032) following the introduction of the training courses in 2000. Antepartum and intrapartum stillbirth at term rates remained unchanged, at about 15 and 4 per 10,000 births, respectively. Conclusion The introduction of obstetric emergencies training courses was associated with a significant reduction in low 5-minute Apgar scores and HIE. This improvement has been sustained as the training has continued. This is the first time an educational intervention has been shown to be associated with a clinically important, and sustained, improvement in perinatal outcome.
Translated title of the contributionDoes training in obstetric emergencies improve neonatal outcome?
Original languageEnglish
Pages (from-to)177 - 182
Number of pages5
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume113 (2)
Publication statusPublished - Feb 2006

Bibliographical note

Publisher: Blackwell


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