Shoulder dystocia: Predictors and outcome: A five-year review

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Abstract

Shoulder dystocia is an uncommon complication of delivery with a high morbidity rate. Ninety-one cases were coded for shoulder dystocia at the Toronto General Hospital from 1980 through 1985. True shoulder dystocia was found in 24 cases, an incidence of 0.23%. There was no significant difference in average weight and percentage of macrosomia between cases of true shoulder dystocia and those merely coded as such. True shoulder dystocia was associated with a neonatal morbidity rate of 42%, consisting of a respiratory arrest and neurological and orthopedic damage. Fundal pressure, in the absence of other maneuvers, resulted in a 77% complication rate and was strongly associated with orthopedic and neurologic damage. Delivery of the posterior shoulder and the corkscrew maneuver were associated with good fetal outcome.

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    Citation Excerpt :

    Other studies have found abnormalities in the first phase of labor.41,42 A few studies have noted a prolonged second stage of labor in those patients with shoulder dystocia,1,3,42 one study showed an increased incidence of SD from 11% to 39%.3 This finding has been noted particularly in nulliparous patients in some studies.43,44

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Presented at the Forty-second Annual Meeting of The Society of Obstetricians and Gynaecologists of Canada, Charlottetown, Prince Edward Island, Canada, June 23–27, 1986.

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