Shoulder dystocia: Definitions and incidence

Abstract Though subjective in nature, both the American College of Obstetricians and Gynecologists practice bulletin and the Royal College of Obstetricians and Gynaecologists green guideline are in agreement on the descriptor of shoulder dystocia: requirement of additional obstetric maneuvers when g...

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Bibliographic Details
Published in:Seminars in perinatology 2014-06, Vol.38 (4), p.184-188
Main Authors: Hansen, Alexandra, MD, Chauhan, Suneet P., MD
Format: Article
Language:English
Subjects:
Cesarean Section - statistics & numerical data
Delivery, Obstetric - methods
Diabetes
Dystocia - epidemiology
Dystocia - therapy
Episiotomy - statistics & numerical data
Female
Guidelines
Humans
Incidence
Infant, Newborn
Male
Neonatal and Perinatal Medicine
Operative vaginal delivery
Practice Guidelines as Topic
Pregnancy
Risk Factors
Shoulder dystocia
Shoulder Injuries
Terminology as Topic
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Summary:Abstract Though subjective in nature, both the American College of Obstetricians and Gynecologists practice bulletin and the Royal College of Obstetricians and Gynaecologists green guideline are in agreement on the descriptor of shoulder dystocia: requirement of additional obstetric maneuvers when gentle downward traction has failed to affect the delivery of the shoulders. The rate of shoulder dystocia is about 1.4% of all deliveries and 0.7% for vaginal births. Compared to non-diabetics (0.6%), among diabetics, the rate of impacted shoulders is 201% higher (1.9%); newborns delivered by vacuum or forceps have 254% higher likelihood of shoulder dystocia than those born spontaneously (2.0% vs. 0.6%, respectively). When the birthweight is categorized as 4500 g, the likelihood of shoulder dystocia in the US vs. other countries varies significantly. Future studies should focus on lowering the rate of shoulder dystocia and its associated morbidities, without concomitantly increasing the rate of cesarean delivery.
ISSN:0146-0005
1558-075X
DOI:10.1053/j.semperi.2014.04.002