title: Shoulder dystocia: nursing prevention and posttrauma care.
abstract: Shoulder dystocia is a birth emergency that occurs in approximately 1% of all births. Shoulder dystocia can be followed by broken clavicle or humerus, brachial plexus injury, fetal hypoxia, or death. Although risk factors for shoulder dystocia include previous birth complicated by shoulder dystocia, maternal obesity, excessive prenatal weight gain, fetal macrosomia, gestational diabetes, and instrumental delivery, shoulder dystocia is not predictable. Perinatal nurses can reduce the risk for shoulder dystocia by teaching mothers about optimal weight gain in pregnancy and assisting mothers with diabetes to prevent hyperglycemia through diet management and medication use. During childbirth preparation or early labor, nurses can educate mothers about position changes and maneuvers used for shoulder dystocia. Nurses play a vital role in obtaining assistance during a shoulder dystocia, keeping time, assisting with maneuvers such as suprapubic pressure, and documenting the dystocia management. Nurses can assist mothers and families to review the shoulder dystocia and any newborn injuries in the postpartum period, thereby reducing confusion and anxiety. Regular drills and case reviews help build nursing shoulder dystocia management skills.
authors.affiliation: University of South Florida College of Nursing, Tampa, FL 33612, USA. cjevitt@health.usf.edu
authors.forename: Cecilia M
authors.initials: CM
authors.lastname: Jevitt
authors.forename: Shannon
authors.initials: S
authors.lastname: Morse
authors.forename: Yong Sue
authors.initials: YS
authors.lastname: O'Donnell
mesh_terms: D001720:Birth Injuries / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000517:prevention & control; D015984:Causality; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods / Q000451:nursing; D004420:Dystocia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005320:Fetal Macrosomia / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D017283:Neonatal Nursing / Q000458:organization & administration*; D024802:Nurse's Role; D009730:Nursing Assessment; D009765:Obesity / Q000150:complications / Q000517:prevention & control; D010353:Patient Education as Topic; D018743:Perinatal Care / Q000458:organization & administration; D011181:Postnatal Care / Q000458:organization & administration; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D011254:Pregnancy in Diabetics / Q000517:prevention & control; D011295:Prenatal Care / Q000458:organization & administration; D018570:Risk Assessment; D012782:Shoulder; D015430:Weight Gain