After shoulder dystocia: managing the subsequent pregnancy and delivery.
Among risk factors for shoulder dystocia, a prior history of delivery complicated by shoulder dystocia is the single greatest risk factor for shoulder dystocia occurrence, with odds ratios 7 to 10 times that of the general population. Recurrence rates have been reported to be as high as 16%. Whereas prevention of shoulder dystocia in the general population is neither feasible nor cost-effective, intervention efforts directed at the particular subgroup of women with a prior history of shoulder dystocia can concentrate on potentially modifiable risk factors and individualized management strategies that can minimize recurrence and the associated significant morbidities and mortality.
Gurewitsch
Edith D
ED
Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. dgurewi@jhmi.edu
Johnson
Tara L
TL
Allen
Robert H
RH
D036861:Delivery, Obstetric; D004420:Dystocia / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011295:Prenatal Care; D012008:Recurrence; D012307:Risk Factors; D000070599:Shoulder Injuries