title: Complications of shoulder dystocia.
abstract: Complications of shoulder dystocia are divided into fetal and maternal. Fetal brachial plexus injury (BPI) is the most common fetal complication occurring in 4-40% of cases. BPI has also been reported in abdominal deliveries and in deliveries not complicated by shoulder dystocia. Fractures of the fetal humerus and clavicle occur in about 10.6% of cases of shoulder dystocia and usually heal with no sequel. Hypoxic ischemic brain injury is reported in 0.5-23% of cases of shoulder dystocia. The risk correlates with the duration of head-to-body delivery and is especially increased when the duration is >5 min. Fetal death is rare and is reported in 0.4% of cases. Maternal complications of shoulder dystocia include post-partum hemorrhage, vaginal lacerations, anal tears, and uterine rupture. The psychological stress impact of shoulder dystocia is under-recognized and deserves counseling prior to home discharge.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Nafisa K
authors.initials: NK
authors.lastname: Dajani
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR. Electronic address: efmagann@uams.edu.
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
mesh_terms: D000328:Adult; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000517:prevention & control*; D001930:Brain Injuries / Q000209:etiology / Q000517:prevention & control*; D003376:Counseling; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods*; D004420:Dystocia / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D004841:Episiotomy; D005260:Female; D005313:Fetal Death / Q000209:etiology / Q000517:prevention & control*; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008499:Medical Records; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D000070599:Shoulder Injuries
keywords: Brachial plexus injury; Complications of pregnancy; Neonatal encepholapathy; Shoulder dystocia