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 ?
He had a severe shoulder dystocia and was born after his mother had a symphsiotomy.
Regarding neonatal complications; there was increased risk of macrosomia (28.2% vs 10.3%, p=0.001), shoulder dystocia or birth trauma (27.2% vs 6.2%, p less than 0.001) and jaundice (29.1% vs 10.3%, p=0.001).
Iris, who weighed 11lb 9oz, had got stuck during delivery due to a rare medical emergency called shoulder dystocia.
Nassir encountered shoulder dystocia. He instituted the McRoberts maneuver followed by suprapubic pressure and the Woods maneuver, all of which were unsuccessful.
CASE FACTS: Samantha Donaldson was alleged to have suffered Erbs Palsy in her right shoulder and arm as a result of an improperly performed shoulder dystocia delivery.
It has been reported between 2 to 7 per 1000 live birth.1,2 Birth related trauma was suggested to be mostly due to difficult vaginal delivery especially with the shoulder in the vertex presentation and extended arms in a breech delivery, shoulder dystocia, and use of forceps instruments.3,4 However, such fractures may also occur when a baby is of average weight and the delivery is not complicated.
26.9%; p=0.02), a higher risk of shoulder dystocia (4% v.
Treating mild gestational diabetes lowered the risks of fetal overgrowth, shoulder dystocia, cesarean delivery, and gestational hypertension, as well as decreasing maternal weight gain, according to a report in almost 1,000 women.
One of the most dangerous predicaments confronting midwives, doctors and obstetricians is shoulder dystocia. Survival of the baby depends on staff being trained in the rapid performance of a range of clinical manoeuvres.
Shoulder dystocia and birth injury; prevention and treatment, 3d ed.
Dr William Zavanelli, a pioneer in the field of shoulder dystocia, who is travelling from California for the conference, pioneered a revolutionary technique known as 'the Zavanelli manoeuvre' for dealing with the emergency.
For example, the "Shoulder Dystocia" and "Shoulder Dystocia Expert Deposition Collection" litigation packets explore obstetrical standard-of-care issues regarding diagnosis of shoulder dystocia and prevention of fetal trauma.