Shoulder dystocia: a study of 47 cases.
Shoulder dystocia at vaginal delivery occurred in 0.2% of cases. Antenatal prediction of this complication was very difficult. In primigravidae in labour, delay late in the first stage was a warning sign; induction of labour, the use of regional analgesia, and forceps delivery for delay in the second stage of labour were associated with subsequent shoulder dystocia, although a cause-effect relationship was not established. The immediate maternal and fetal morbidity were high, nearly 30% of the babies suffering from a severe neural or bony injury. Forty-four per cent of the babies were beyond 41 weeks of gestation, and 70% weighed over 4,000 g. The avoidance of postmaturity by elective induction of labour at 41 weeks of gestation would significantly reduce the incidence of shoulder impaction at delivery.
D000773:Anesthesia, Obstetrical / Q000379:methods; D001724:Birth Weight; D036861:Delivery, Obstetric / Q000379:methods; D004420:Dystocia / Q000209:etiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications; D011247:Pregnancy; D012189:Retrospective Studies; D012782:Shoulder