Recurrent Shoulder Dystocia: Risk Factors and Counseling.
A prior history of delivery complicated by shoulder dystocia confers a 6-fold to nearly 30-fold increased risk of shoulder dystocia recurrence in a subsequent vaginal delivery, with most reported rates between 12% and 17%. Whereas prevention of shoulder dystocia in the general population is neither feasible nor cost-effective, directing intervention efforts at the particular subgroup of women with a prior history of shoulder dystocia has merit. Potentially modifiable risk factors and individualized management strategies that may reduce shoulder dystocia recurrence and its associated significant morbidities are reviewed.
Departments of Gynecology/Obstetrics & Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Edith D
ED
Gurewitsch Allen
D003376:Counseling; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000706:statistics & numerical data; D004420:Dystocia / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D011247:Pregnancy; D012008:Recurrence; D017584:Reproductive History; D012307:Risk Factors; D012782:Shoulder