Twin vaginal delivery: To maintain skill - simulation is required.


Journal

European journal of obstetrics, gynecology, and reproductive biology
ISSN: 1872-7654
Titre abrégé: Eur J Obstet Gynecol Reprod Biol
Pays: Ireland
ID NLM: 0375672

Informations de publication

Date de publication:
Mar 2019
Historique:
received: 02 10 2018
revised: 29 11 2018
accepted: 28 12 2018
pubmed: 4 2 2019
medline: 6 6 2019
entrez: 4 2 2019
Statut: ppublish

Résumé

Although most societies of obstetrics advocate vaginal delivery of twins, there has been a steady rise in the rate of twin cesarean sections. We risk perhaps losing in a single generation our obstetrical learning and skills because of medicolegal and emotionally charged issues. We have therefore designed a realistic as possible simulation model of second twin delivery and tested it on residents in obstetrics. Between two trials, we noted a significant improvement in the time required for internal podalic version and breech extraction. We also observed a significant improvement in the confidence score between the two trials. We have designed a simulation device that improves obstetrical skills for second twin delivery and which we hope will participate in the comeback of vaginal delivery for this indication and contribute to the fight against the dangerous trend of rising rates of cesarean delivery for twins. Our model completely fits the paradigm of simulation in medical pedagogy.

Sections du résumé

BACKGROUND BACKGROUND
Although most societies of obstetrics advocate vaginal delivery of twins, there has been a steady rise in the rate of twin cesarean sections. We risk perhaps losing in a single generation our obstetrical learning and skills because of medicolegal and emotionally charged issues.
METHODS METHODS
We have therefore designed a realistic as possible simulation model of second twin delivery and tested it on residents in obstetrics.
FINDINGS RESULTS
Between two trials, we noted a significant improvement in the time required for internal podalic version and breech extraction. We also observed a significant improvement in the confidence score between the two trials.
INTERPRETATION CONCLUSIONS
We have designed a simulation device that improves obstetrical skills for second twin delivery and which we hope will participate in the comeback of vaginal delivery for this indication and contribute to the fight against the dangerous trend of rising rates of cesarean delivery for twins. Our model completely fits the paradigm of simulation in medical pedagogy.

Identifiants

pubmed: 30711812
pii: S0301-2115(19)30025-9
doi: 10.1016/j.ejogrb.2018.12.038
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

195-199

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Auteurs

Julien Lepage (J)

Hôpital Bichat, Maternité Aline de Crepy, APHP, 75018, Paris, France; Université Paris Diderot, Paris 7, Paris, France.

Pierre Francois Ceccaldi (PF)

Université Paris Diderot, Paris 7, Paris, France; Hôpital Beaujon, Service de gynécologie obstétrique, APHP, 92110, Clichy, France; Ilumens Paris Diderot, Centre de simulation, Paris, France; DHU Risk and Pregnancy (Paris V and Paris VII University), France.

Sid Ahmed Remini (SA)

Ilumens Paris Diderot, Centre de simulation, Paris, France.

Patrick Plaisance (P)

Université Paris Diderot, Paris 7, Paris, France; Ilumens Paris Diderot, Centre de simulation, Paris, France; Hôpital Lariboisière, Emergency Unit, APHP, 75018, Paris, France.

Audrey Voulgaropoulos (A)

Hôpital Bichat, Maternité Aline de Crepy, APHP, 75018, Paris, France.

Dominique Luton (D)

Hôpital Bichat, Maternité Aline de Crepy, APHP, 75018, Paris, France; Université Paris Diderot, Paris 7, Paris, France; Ilumens Paris Diderot, Centre de simulation, Paris, France; DHU Risk and Pregnancy (Paris V and Paris VII University), France. Electronic address: dluton@free.fr.

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