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By: Ritu . and Anshika Rosha.
Shoulder dystocia is a serious and potentially life-threatening complication that can occur during childbirth, characterized by the baby’s shoulder becoming stuck in the mother’s pelvic area after the head has been delivered. This obstructed delivery can lead to severe difficulties in the birth process, requiring immediate and skilled intervention to prevent harm to both the mother and baby. Shoulder dystocia occurs when one or both of the baby’s shoulders are too wide to pass through the birth canal, or when the baby’s positioning causes the shoulders to become lodged against the mother’s pelvis. It is typically unpredictable and can happen during a vaginal delivery, even when there are no apparent risk factors. This condition is classified as an obstetric emergency because of the immediate risks it poses. For the baby, complications such as brachial plexus injury (nerve damage), fractures (especially of the clavicle), or oxygen deprivation (hypoxia) can occur due to the prolonged time the baby spends in the birth canal. These risks can lead to short- or long-term physical and neurological impairments, including Erb’s palsy, a form of paralysis caused by nerve damage in the arm. Furthermore, lack of oxygen can result in brain injury or, in the most extreme cases, death. For the mother, shoulder dystocia can lead to significant complications such as severe bleeding (postpartum hemorrhage), uterine rupture, or genital trauma. These outcomes may necessitate surgery and can lead to longer recovery periods and a higher risk of complications in future pregnancies. Early recognition of shoulder dystocia is critical to improving outcomes, as timely and effective interventions can resolve the situation in the majority of cases. Skilled management, including the use of specific maneuvers and sometimes the assistance of specialized equipment, is essential for ensuring the safety of both the mother and the baby. When managed promptly and effectively, most cases of shoulder dystocia are resolved without long-term harm.
Keywords :- Child birth, Shoulder dystocia, Pelvis, Trauma, Oxygen
Citation:
Refrences:
1. Gottlieb AG, Galan HL. Shoulder dystocia: an update. Obstet Gynecol Clin North Am. 2007 Sep;34(3):501-31, xii. doi: 10.1016/j.ogc.2007.07.002. PMID: 17921012.
2. Tsikouras P, Kotanidou S, Nikolettos K, Kritsotaki N, Bothou A, Andreou S, Nalmpanti T, Chalkia K, Spanakis V, Peitsidis P, Iatrakis G, Nikolettos N. Shoulder Dystocia: A Comprehensive Literature Review on Diagnosis, Prevention, Complications, Prognosis, and Management. J Pers Med. 2024 May 30;14(6):586. doi: 10.3390/jpm14060586. PMID: 38929807; PMCID: PMC11204412.
3. Morrison JC, Sanders JR, Magann EF, Wiser WL. The diagnosis and management of dystocia of the shoulder. Surg Gynecol Obstet. 1992 Dec;175(6):515-22. PMID: 1448731.
4. Jevitt CM. Shoulder dystocia: etiology, common risk factors, and management. J Midwifery Womens Health. 2005 Nov-Dec;50(6):485-97. doi: 10.1016/j.jmwh.2005.07.005. PMID: 16260363.
5. Walsh JM, Kandamany N, Ni Shuibhne N, Power H, Murphy JF, O’Herlihy C. Neonatal brachial plexus injury: comparison of incidence and antecedents between 2 decades. Am J Obstet Gynecol. 2011 Apr;204(4):324.e1-6. doi: 10.1016/j.ajog.2011.01.020. Epub 2011 Feb 23. PMID: 21345417.
6. Doumouchtsis SK, Arulkumaran S. Are all brachial plexus injuries caused by shoulder dystocia? Obstet Gynecol Surv. 2009 Sep;64(9):615-23. doi: 10.1097/OGX.0b013e3181b27a3a. PMID: 19691859.
7. Hankins GD, Clark SM, Munn MB. Cesarean section on request at 39 weeks: impact on shoulder dystocia, fetal trauma, neonatal encephalopathy, and intrauterine fetal demise. Semin Perinatol. 2006 Oct;30(5):276-87. doi: 10.1053/j.semperi.2006.07.009. PMID: 17011400.
8. Inglis SR, Feier N, Chetiyaar JB, Naylor MH, Sumersille M, Cervellione KL, Predanic M. Effects of shoulder dystocia training on the incidence of brachial plexus injury. Am J Obstet Gynecol. 2011 Apr;204(4):322.e1-6. doi: 10.1016/j.ajog.2011.01.027. Epub 2011 Feb 24. PMID: 21349495.
9. Kees S, Margalit V, Schiff E, Mashiach S, Carp HJ. Features of shoulder dystocia in a busy obstetric unit. J Reprod Med. 2001 Jun;46(6):583-8. PMID: 11441684.
10. Mehta SH, Blackwell SC, Bujold E, Sokol RJ. What factors are associated with neonatal injury following shoulder dystocia? J Perinatol. 2006 Feb;26(2):85-8. doi: 10.1038/sj.jp.7211441. PMID: 16407959.