The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis

Abstract Introduction Little is known about the optimal simulation‐based team training in obstetric emergencies. We aimed to review how simulation‐based team training affects patient outcomes in obstetric emergencies. Material and methods Search Strategy: MEDLINE, Embase, Cochrane Library, and Cochr...

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Main Authors: Lise Brogaard, Kasper Glerup Lauridsen, Bo Løfgren, Kristian Krogh, Charlotte Paltved, Sidsel Boie, Lone Hvidman
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14263
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author Lise Brogaard
Kasper Glerup Lauridsen
Bo Løfgren
Kristian Krogh
Charlotte Paltved
Sidsel Boie
Lone Hvidman
author_facet Lise Brogaard
Kasper Glerup Lauridsen
Bo Løfgren
Kristian Krogh
Charlotte Paltved
Sidsel Boie
Lone Hvidman
author_sort Lise Brogaard
collection DOAJ
description Abstract Introduction Little is known about the optimal simulation‐based team training in obstetric emergencies. We aimed to review how simulation‐based team training affects patient outcomes in obstetric emergencies. Material and methods Search Strategy: MEDLINE, Embase, Cochrane Library, and Cochrane Central Register of Controlled Trials were searched up to and including May 15, 2021. Selection criteria: randomized controlled trials (RCTs) and cohort studies on obstetric teams in high‐resource settings comparing the effect of simulation‐based obstetric emergency team training with no training on the risk of Apgar scores less than 7 at 5 min, neonatal hypoxic ischemic encephalopathy, severe postpartum hemorrhage, blood transfusion of four or more units, and delay of emergency cesarean section by more than 30 min. Data collection and analysis: The included studies were assessed using PRISMA, EPCO, and GRADE. Results We found 21 studies, four RCTs and 17 cohort studies, evaluating patient outcomes after obstetric team training compared with no training. Annual obstetric emergency team training may reduce brachial plexus injury (six cohort studies: odds ratio [OR] 0.47, 95% CI 0.33–0.68; one RCT: OR 1.30, 95 CI% 0.39–4.33, low certainty evidence) and suggest a positive effect; but it was not significant on Apgar score below 7 at 5 min (three cohort studies: OR 0.77, 95% CI 0.51–1.19; two RCT: OR 0.87, 95% CI 0.72–1.05, moderate certainty evidence). The effect was unclear for hypoxic ischemic encephalopathy, umbilical prolapse, decision to birth interval in emergency cesarean section, and for severe postpartum hemorrhage. Studies with in situ multi‐professional simulation‐based training demonstrated the best effect. Conclusions Emerging evidence suggests an effect of obstetric team training on obstetric outcomes, but conflicting results call for controlled trials targeted to identify the optimal methodology for effective team training.
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spelling doaj-art-ac300e185c7a49d080e35e78712f25ef2025-08-20T02:36:42ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122022-01-011011253610.1111/aogs.14263The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysisLise Brogaard0Kasper Glerup Lauridsen1Bo Løfgren2Kristian Krogh3Charlotte Paltved4Sidsel Boie5Lone Hvidman6Department of Obstetrics and Gynecology Aarhus University Hospital Aarhus DenmarkResearch Center for Emergency Medicine Aarhus University Hospital Aarhus DenmarkDepartment of Clinical Medicine Aarhus University Aarhus DenmarkResearch Center for Emergency Medicine Aarhus University Hospital Aarhus DenmarkDepartment of Human Resources Medical simulation in Central Denmark Region (MidtSim) Aarhus DenmarkDepartment of Obstetrics and Gynecology Randers Regional Hospital Randers DenmarkDepartment of Obstetrics and Gynecology Aarhus University Hospital Aarhus DenmarkAbstract Introduction Little is known about the optimal simulation‐based team training in obstetric emergencies. We aimed to review how simulation‐based team training affects patient outcomes in obstetric emergencies. Material and methods Search Strategy: MEDLINE, Embase, Cochrane Library, and Cochrane Central Register of Controlled Trials were searched up to and including May 15, 2021. Selection criteria: randomized controlled trials (RCTs) and cohort studies on obstetric teams in high‐resource settings comparing the effect of simulation‐based obstetric emergency team training with no training on the risk of Apgar scores less than 7 at 5 min, neonatal hypoxic ischemic encephalopathy, severe postpartum hemorrhage, blood transfusion of four or more units, and delay of emergency cesarean section by more than 30 min. Data collection and analysis: The included studies were assessed using PRISMA, EPCO, and GRADE. Results We found 21 studies, four RCTs and 17 cohort studies, evaluating patient outcomes after obstetric team training compared with no training. Annual obstetric emergency team training may reduce brachial plexus injury (six cohort studies: odds ratio [OR] 0.47, 95% CI 0.33–0.68; one RCT: OR 1.30, 95 CI% 0.39–4.33, low certainty evidence) and suggest a positive effect; but it was not significant on Apgar score below 7 at 5 min (three cohort studies: OR 0.77, 95% CI 0.51–1.19; two RCT: OR 0.87, 95% CI 0.72–1.05, moderate certainty evidence). The effect was unclear for hypoxic ischemic encephalopathy, umbilical prolapse, decision to birth interval in emergency cesarean section, and for severe postpartum hemorrhage. Studies with in situ multi‐professional simulation‐based training demonstrated the best effect. Conclusions Emerging evidence suggests an effect of obstetric team training on obstetric outcomes, but conflicting results call for controlled trials targeted to identify the optimal methodology for effective team training.https://doi.org/10.1111/aogs.14263birthbrachial plexusdeliveryemergency teamsobstetricpostpartum hemorrhage
spellingShingle Lise Brogaard
Kasper Glerup Lauridsen
Bo Løfgren
Kristian Krogh
Charlotte Paltved
Sidsel Boie
Lone Hvidman
The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
Acta Obstetricia et Gynecologica Scandinavica
birth
brachial plexus
delivery
emergency teams
obstetric
postpartum hemorrhage
title The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
title_full The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
title_fullStr The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
title_full_unstemmed The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
title_short The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
title_sort effects of obstetric emergency team training on patient outcome a systematic review and meta analysis
topic birth
brachial plexus
delivery
emergency teams
obstetric
postpartum hemorrhage
url https://doi.org/10.1111/aogs.14263
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