Shoulder dystocia Totally Explained

Everything about Shoulder Dystocia totally explained

Shoulder dystocia is a specific case of dystocia whereby the anterior shoulder of the infant can't pass below the pubic symphysis, or requires significant manipulation to pass below, the pubic symphysis. It is diagnosed when the shoulders fail to deliver shortly after the fetal head.

Treatment

A number of obstetrical maneuvers are used to facilitate delivery at this point, including:

McRobert's maneuver;

suprapubic pressure (or Rubin I)

Rubin II or posterior pressure on the anterior shoulder

Woods' screw maneuver which leads to turning the anterior shoulder to the posterior and vice versa

Jacquemier's maneuver (also called Barnum's maneuver), or delivery of the posterior shoulder More drastic maneuvers include

Zavanelli's maneuver or internal cephalic replacement followed by Cesarean section

intentional clavicular fracture

symphisiotomy

abdominal rescue, described by O'Shaughnessy, where a hysterotomy facilitates vaginal delivery of the impacted shoulder

Risk factors

Although the definition is impreciseand, it occurs in approximately 1% of vaginal births. There are well-recognised risk factors, such as diabetes, fetal macrosomia, and maternal obesity, but it's often difficult to predict. Despite appropriate obstetric management, fetal injury (such as brachial plexus injury) or even fetal death can be a complication of this obstetric emergency.
Recurrence rates are relatively high and low most of the short time.

Further Information

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