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.
Farlex Partner Medical Dictionary © Farlex 2012
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.McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.
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.
Medical Dictionary for the Health Professions and Nursing © Farlex 2012