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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 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 <4000, 4000-4449, and >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.
AuthorsAlexandra Hansen, Suneet P Chauhan
JournalSeminars in perinatology (Semin Perinatol) Vol. 38 Issue 4 Pg. 184-8 (Jun 2014) ISSN: 1558-075X [Electronic] United States
PMID24863022 (Publication Type: Journal Article, Review)
CopyrightCopyright © 2014 Elsevier Inc. All rights reserved.
Topics
  • Cesarean Section (statistics & numerical data)
  • Delivery, Obstetric (methods)
  • Dystocia (epidemiology, therapy)
  • Episiotomy (statistics & numerical data)
  • Female
  • Humans
  • Incidence
  • Infant, Newborn
  • Male
  • Practice Guidelines as Topic
  • Pregnancy
  • Risk Factors
  • Shoulder Injuries
  • Terminology as Topic

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