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Shoulder dystocia: Treatment, symptoms, advice and help

About shoulder dystocia

It is a condition during vaginal delivery when there is difficulty in delivering the shoulders of the foetus after the head is delivered. Head to body delivery time exceeding 60 seconds is taken as shoulder dystocia.

Shoulder dystocia: Incidence, age and sex

The incidence varies from 0.6% to 1.4%. The incidence is more with bigger babies due to diabetes in mothers. The incidence increases with increasing birth order as the birth weight increases.

Signs and symptoms of shoulder dystocia: Diagnosis

The condition is detected in the second stage of labour after the head is delivered. There is difficulty in delivering the shoulders with usual gentle traction.

Causes and prevention of shoulder dystocia

Maternal obesity, diabetes and multi parity are important risk factors. Pregnancies prolonging beyond 42 weeks are also at higher risk as the foetus in some cases continues to grow. Previous history of shoulder dystocia and expected birth weight more than 4.5 kg are important factors to predict this condition. Elective cesarean section may avert this situation, especially in big babies of diabetic women.

Shoulder dystocia: Treatment

Gentle traction, liberal episiotomy and sharply flexing the thighs of the woman over her abdomen are important maneuvers to deliver the shoulder. If these measures fail then more skilled maneuvers are carried out.

Shoulder dystocia: Complications

Injury to the collar bone of the fetus and damage to the brachial nerve plexus like Erb’s palsy are significant morbidity to the foetus. If neglected, the condition may even result in death of the foetus.