[Shoulder dystocia: a ten-year descriptive study in a level-III maternity unit].
OBJECTIVE
Shoulder dystocia is one of the most dreadful complications of vaginal deliveries. The aim of this observational study was to evaluate risk factors of dystocia, maternal and neonatal complications and recurrent risk factors.


METHODS
Sixty-six cases of shoulder dystocia occurring between January 1998 and August 2008 in our university hospital were identified. Demographic data, labor management, management of the shoulder dystocia and neonatal outcome were recorded.


RESULTS
The incidence of shoulder dystocia was 0.3%. Multiparity, weight gain greater than 12 kg, and post-term delivery were more present in our study group. McRoberts' manoeuver and symphyseal pressure were first realised. Brachial plexus injuries affected 9% of neonates with skeletal fractures in 7.5% of cases. Maternal morbidity was evaluated at about 8%. Twenty per cent had a recurrent shoulder dystocia.


CONCLUSIONS
Shoulder dystocia is an obstetric emergency which requires a prompt management of trained personnel. Despite the difficulty of being able to prevent shoulder dystocia, training the obstetric staff could probably improve management of shoulder dystocia.
Lima
S
S
Service de gynécologie-obstétrique, hôpital Nord, CHU de Saint-Etienne, avenue Albert-Raimond, 42270 Saint-Priest, Jarez, France.
Chauleur
C
C
Varlet
M-N
MN
Guillibert
F
F
Patural
H
H
Collet
F
F
Seffert
P
P
Chêne
G
G
D001720:Birth Injuries / Q000453:epidemiology; D001917:Brachial Plexus / Q000293:injuries*; D036861:Delivery, Obstetric / Q000009:adverse effects; D004420:Dystocia / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D015430:Weight Gain; D014947:Wounds and Injuries / Q000517:prevention & control