Abstract
Postpartum hemorrhage (PPH) continues to be the leading cause of maternal mortality worldwide, occurring in about five percent of deliveries. The most common cause of PPH is uterine atony, and a number of medical and surgical management techniques are available to prevent morbidity and mortality associated with PPH in this context. Uterine compression sutures provide a more conservative surgical approach, allowing for the preservation of fertility. Obstetrics and Gynecology (Ob/Gyn) residents need to be adequately trained to competently perform this technique.The goal of this surgical skills training is for Ob/Gyn residents to be able to surgically manage PPH using uterine compression sutures. A uterine towel model for surgical skills training in the use of uterine compression sutures was developed. The simulator is explained and compared to similar models. Possible ways to implement and use the simulator in a simulation curriculum are also described. A performance-based assessment rubric was also developed in order to formatively aid with the learning and understanding of the technique. Much work is still needed to test the validity and reliability of this tool, but based on current literature, results may be promising.
Highlights
BackgroundThe problem and needPostpartum hemorrhage (PPH) continues to be the leading cause of maternal mortality worldwide, occurring in about five percent of deliveries
The Royal College “Objectives of Training” for Obstetrics and Gynecology (Ob/Gyn) state that extensive knowledge is required for the “etiology and management, medical and surgical, of early and delayed postpartum hemorrhage” and that a fully trained resident must be competent to perform independently both “nonsurgical and surgical management of moderate and severe postpartum hemorrhage.”
This includes the use of uterine compression sutures [3]
Summary
Postpartum hemorrhage (PPH) continues to be the leading cause of maternal mortality worldwide, occurring in about five percent of deliveries. It describes a four-station OSAT, including a GRS and a task-specific checklist for the uterine compression suture station [14]. This may be expanded to a larger scale (e.g., five) if pilot studies show any threats to reliability or validity or if it is felt that level four (proficient) and five (expert) need to be defined
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