shoulder dystocia


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shoulder dystocia

arrest of normal labor after delivery of the head by impaction of the anterior shoulder against the symphysis pubis.

shoulder dystocia

Obstetrics An obstetrical emergency that occurs when the anterior shoulder of the fetus becomes lodged behind the superior symphysis pubis, preventing further delivery; SD is not always preventable, and is usually not recognized until after the head has been delivered, and gentle downward traction of the fetal head fails to accomplish delivery Incidence Up to 2% of deliveries–probably underreported Risk factors Maternal obesity >250 lbs–9 X risk, excess weight gain during pregnancy; DM–5-16.7% vs 1.7% in controls; postterm pregnancy–fetal growth does not stop at 40 wks; inertia of macrosomia; abnormal labor  with prolonged deceleration, prolonged 2nd stage of labor; operative vaginal delivery–forceps, vacuum extraction Management Mobilize anesthesia and pediatric support ASAP; gentle attempt at downward traction on head and moderate fundal pressure; large episiotomy; suprapubic pressure at midline; attempt to rotate shoulder; fracture the clavicle; cleidotomy; symphysiotomy–rarely done in US; McRobert's manuever–flexing legs on abdomen to ↑ diameter of pelvic outlet; Wood's screw manuever–apply pressure to ventral surface of posterior shoulder; deliver posterior shoulder. See Dystocia.

shoul·der dys·to·ci·a

(shōl'dĕr dis-tō'sē-ă)
Arrest of normal labor after delivery of the head by impaction of the anterior shoulder against the symphysis pubis.
References in periodicals archive ?
The first CAE LucinaAR learning module will provide immediate visual and physiological feedback on the effectiveness of evidence-based clinical emergency measures to resolve shoulder dystocia.
During vaginal delivery, a shoulder dystocia was encountered.
Ms Leonard said she had been involved in births where babies' arms were broken - known as shoulder dystocia - but never one so severe.
Neither woman had a history of epidural analgesia and shoulder dystocia or Mc Roberts maneuver associated with their case.
The 33 contributions also review research findings on analgesia, pregnancy loss, premature rupture of membranes, induction of labor, malposition, shoulder dystocia, placental disorders, and postpartum care.
sup][1] As advised by Hart in 1997, by waiting for a contraction after the head is delivered, the incidence of shoulder dystocia was reduced dramatically.
Shoulder dystocia occurs when after delivery of the foetal head; the baby's anterior shoulder gets stuck behind the mother's pubic bone.
ATLANTA -- Implementation of evidence-based practice bundles was associated with significant reductions in shoulder dystocia, brachial plexus injury, and operative vaginal delivery in a large multicenter hospital system.
Birth weight, shoulder dystocia, cord blood for C peptide level estimation, Neonatal sugars--3 and 6 hours, hyperbilirubinaemia is recorded.
Gaumard's complete Victoria system includes comprehensive clinical scenarios, including shoulder dystocia and postpartum hemorrhage.
He had a severe shoulder dystocia and was born after his mother had a symphsiotomy.
7 The short term complications of excess infant birth weight are shoulder dystocia and infant hypoglycemia.