title: [Shoulder dystocia].
abstract: In this study, 49 cases of shoulder dystocia have been examined. These cases took place in Athens University Second Gynecological and Obstetrics Department, over a period of ten years, from 1975 to 1985. In 23 cases, the delivery was normal, in 20 cases it was necessary to use a vacuum extractor and in 6 cases a forceps. In none of the above cases was there a Cesarean Section, because the cases were not regarded as a fetopelvic disproportion, but as cases which justify normal delivery. There follows a general outline of the treatment to be applied in cases of shoulder dystocia, including a generous episiotomy, the application, if possible, of a muscular relaxation by inhalation anesthesia, and the application of certain obstetric manipulations. In our cases, we applied general anesthesia in 7 cases and local in 39, whereas in 3 was no anesthesia at all. The obstetric manipulations we applied were those of McRoberts in 15 cases, of Jacquemier in 10 cases, of Wood in 15 cases, of Barnum in 5 cases, of Hibbard in 8 cases and of Couder in 6 cases. Our results also appear in tables I and II. In 36 cases, out of 49, (73.49%), the fetal weight was over 4,000 g. In 23 cases (47%) the mother had gained 12 kg during pregnancy. Also, in our study, 20% of the cases (10 mothers) were multiparous and 45% (22 mothers) had a prolonged second stage of labour by more than one hour. Class A (by White) diabetes was found in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Hôpital Areteio, Deuxième Clinique Obstétricale et Gynécologique de lpUniversité d'Athènes, Grèce.
authors.forename: O
authors.initials: O
authors.lastname: Gregoriou
authors.forename: A
authors.initials: A
authors.lastname: Maragoudakis
authors.forename: K
authors.initials: K
authors.lastname: Papadias
authors.forename: S
authors.initials: S
authors.lastname: Konidaris
authors.forename: P
authors.initials: P
authors.lastname: Zourlas
mesh_terms: D000328:Adult; D004420:Dystocia / Q000150:complications / Q000209:etiology*; D005260:Female; D006801:Humans; D007746:Labor Presentation; D011247:Pregnancy; D012782:Shoulder
vernacular_title: La dystocie des épaules.