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Impact of multi disciplinary education on intrauterine resuscitation
Abstract Number: T 19
Abstract Type: Original Research
Introduction: Effective management of foetal distress is a multi disciplinary effort. There are established resuscitative techniquesas well as discussion on more controversial methods. The underlying pathophysiology needs to be understood to implement correct treatment. We carried out multi disciplinary teaching sessions, produced educational posters and distributed action plan cards. Our aim was to promote the underlying pathophysiology in foetal distress and their corrective treatment measures. We audited resuscitative measures that were being used in cases of foetal distress prior to LSCS before and after our intervention.
Methods: Data was collected over a 6 month period from all category 1 and 2 LSCS, where foetal distress was present. We asked: was the mother tilted, were IV fluids running and was oxygen being administered. During the last 8 weeks of the audit cycle we also collected data on the use of syntocinon, we asked if sytocinon had been administered, and there was now the presence of foetal distress, was it still running? We re audited after our education program for a further 6-month period.
Results:See Table 1.
Discussion: Through multi disciplinary teaching we have demonstrated an improvement in knowledge and clinical skills when dealing with intrauterine resuscitation. Placing mothers in a tilted position is a simple and effective maneuver but is still poorly done. In our first audit we only had partial data with regard to the ongoing use of syntocinon during foetal distress and this may have affected our results, as no improvement was seen. Oxygen administration is a moot point within intra uterine resuscitation, our hospital guidelines state oxygen should be “considered” rather than universally administered, but post education it was used more often during foetal distress. In our second audit cycle 11.7% of category 1 LSCS were down graded to category 2 LSCS. This will impact the anaesthetic technique offered to the mother, allowing time for regional anaesthesia thus providing benefits to the mother and foetus.
1. Thurlow JA, Kineslla SM. Intrauterine resuscitation: active management of fetal distress. Int J Obstetric Anaesthesia 2002;11:105-116.
2. Simpson KR. Intrauterine resuscitation during labour: should maternal oxygen administration be a first line measure? Seminars in Fetal Neonatal Medicine 2008 Dec;13 (6): 362-7