| Shoulder dystocia | |
|---|---|
 | |
| Suprapubic pressure being used in a shoulder dystocia | |
| Specialty | Obstetrics |
| Symptoms | Retraction of the baby's head back into the vagina[1] |
| Complications | Baby: Brachial plexus injury, clavicle fracture[2] Mother: Vaginal or perineal tears, postpartum bleeding[3] |
| Risk factors | Gestational diabetes, previous history of the condition, operative vaginal delivery, obesity in the mother, an overly large baby, epidural anesthesia[2] |
| Diagnostic method | Body fails to deliver within one minute of the head[2] |
| Treatment | McRoberts maneuver, suprapubic pressure, Rubin maneuver, episiotomy, all fours, Zavanelli's maneuver followed by cesarean section[3][2] |
| Frequency | ~ 1% of vaginal births[2] |
Shoulder dystocia is when, after vaginal delivery of the head, the baby's anterior shoulder gets caught above the mother's pubic bone.[3][1] Signs include retraction of the baby's head back into the vagina, known as "turtle sign".[1] Complications for the baby may include brachial plexus injury, or clavicle fracture.[2][1] Complications for the mother may include vaginal or perineal tears, postpartum bleeding, or uterine rupture.[3][1]
Risk factors include gestational diabetes, previous history of the condition, operative vaginal delivery, obesity in the mother, an overly large baby, and epidural anesthesia.[2] It is diagnosed when the body fails to deliver within three minutes of delivery of the baby's head.[2] It is a type of obstructed labour.[4]
Shoulder dystocia is an obstetric emergency.[3] Initial efforts to release a shoulder typically include: with a woman on her back pushing the legs outward and upward, pushing on the abdomen above the pubic bone.[3] If these are not effective, efforts to manually rotate the baby's shoulders or placing the woman on all fours may be tried.[3][2] Shoulder dystocia occurs in approximately 0.4% to 1.4% of vaginal births.[2] Death as a result of shoulder dystocia is very uncommon.[1]
- ^ a b c d e f Gherman, Robert B.; Gonik, Bernard (2009). "Shoulder Dystocia". The Global Library of Women's Medicine. doi:10.3843/GLOWM.10137.
- ^ a b c d e f g h i j Dahlke, JD; Bhalwal, A; Chauhan, SP (June 2017). "Obstetric Emergencies: Shoulder Dystocia and Postpartum Hemorrhage". Obstetrics and Gynecology Clinics of North America. 44 (2): 231–243. doi:10.1016/j.ogc.2017.02.003. PMID 28499533.
- ^ a b c d e f g "Shoulder dystocia" (PDF). Royal College of Obstetricians and Gynaecologists. 2013. Retrieved 3 October 2018.
- ^ Buck, Carol J. (2016). 2017 ICD-10-CM Standard Edition - E-Book. Elsevier Health Sciences. p. 108. ISBN 9780323484572.