Does Simulation Training Improve the Accuracy of Vaginal Assessment of Labour Progress?

Girija Swaminathan,Shashank V Parulekar

doi:10.7759/cureus.16089

Girija Swaminathan, Shashank V Parulekar

Open Access

https://doi.org/10.7759/cureus.16089

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Abstract

AimTo measure the utility of the Simulation training model for training purposes over and above conventional methods of training for vaginal assessment during labour.MethodsThe study group included undergraduate trainees, and the control group included postgraduate trainees and qualified personnel, i.e. senior registrars and consultants. Participants from the study group were trained for vaginal assessment on the simulation training model. Then both the groups were tested on the model for accuracy in estimating each value of cervical dilatation and fetal station. Mean cervical dilatation and station accuracy scores were noted, and comparative analysis was done between the study and control groups.ResultsA total of 150 participants were included. The overall mean dilatation and station accuracy scores of a model trained study group participants were better than subjectively trained control group participants. Study group participants showed greater accuracy for smaller dilatations, i.e. 1, 2, 3, 4cm and middle dilatation, i.e. 5cm and 6cm (p value=<0.05). In contrast, comparing the two groups for higher dilatations from 6 to 10 cm did not show any statistical significance. Study group participants also showed greater accuracy for all the fetal stations except stations 0 and +1.ConclusionsThe simulation training model can be considered an in vitro training device to improve the trainees' understanding of cervical dilatation and fetal station and can be made a part of a routine obstetric teaching program.

Highlights

Progress of labour can be monitored clinically by abdominal palpation and vaginal examination, out of which vaginal examination is the most accepted method of measuring labour progress
The overall mean dilatation and station accuracy scores of a model trained study group participants were better than subjectively trained control group participants
The two main objective criteria used in vaginal examination to assess labour progress are cervical dilatation and descent of the fetal presenting part

Summary

Introduction

Progress of labour can be monitored clinically by abdominal palpation and vaginal examination, out of which vaginal examination is the most accepted method of measuring labour progress. Dilatation of cervical os measured by digital vaginal examination can be used as a sole measure of labour progress. It is usually combined with other clinical observations like position and consistency of cervix and the position and level of descent of the fetal head in the maternal pelvis to aid decision making on labour progress [1]. The two main objective criteria used in vaginal examination to assess labour progress are cervical dilatation and descent of the fetal presenting part. Assessment of cervical dilatation in centimetres is one of the most critical aspects of vaginal examination during labour. The width of fingers assesses conventionally cervical dilatation. Knowledge of cervical dilatation in centimetres is an essential prerequisite of plotting of cervicograph, a graphical representation of cervical dilatation and descent of fetal head on the partogram

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