Shoulder dystocia: predictors and outcome. A five-year review.
Shoulder dystocia is an uncommon complication of delivery with a high morbidity rate. Ninety-one cases were coded for shoulder dystocia at the Toronto General Hospital from 1980 through 1985. True shoulder dystocia was found in 24 cases, an incidence of 0.23%. There was no significant difference in average weight and percentage of macrosomia between cases of true shoulder dystocia and those merely coded as such. True shoulder dystocia was associated with a neonatal morbidity rate of 42%, consisting of a respiratory arrest and neurological and orthopedic damage. Fundal pressure, in the absence of other maneuvers, resulted in a 77% complication rate and was strongly associated with orthopedic and neurologic damage. Delivery of the posterior shoulder and the corkscrew maneuver were associated with good fetal outcome.
D036861:Delivery, Obstetric / Q000295:instrumentation / Q000379:methods; D004420:Dystocia / Q000209:etiology*; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications; D006801:Humans; D007748:Labor Stage, Second; D011247:Pregnancy; D012782:Shoulder