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The Journal of Reproductive Medicine Jun 1975
Topics: Dystocia; Female; Fetal Diseases; Humans; Monitoring, Physiologic; Pregnancy
PubMed: 1151938
DOI: No ID Found -
Midwifery Today With International... 2013
Topics: Delivery, Obstetric; Dystocia; Female; Humans; Infant, Newborn; Labor, Obstetric; Midwifery; Nurse's Role; Pregnancy; Shoulder
PubMed: 23581209
DOI: No ID Found -
Acta Medica Croatica : Casopis... 2002Shoulder dystocia is an unpredictable obstetric complication with the incidence of 0.15% to 2%. An increase in the incidence of shoulder dystocia has been recorded over...
Shoulder dystocia is an unpredictable obstetric complication with the incidence of 0.15% to 2%. An increase in the incidence of shoulder dystocia has been recorded over the last 20 years, probably just because it has now been regularly registered at maternity wards as an obstetric complication. The risk factors for shoulder dystocia include fetal macrosomia, fetal malformations and tumors, maternal adiposity, excessive weight gain during pregnancy, diabetes mellitus, pathologic pelvis, multiparity, short maternal stature, advanced maternal age, postterm pregnancy, so-called midforceps delivery or vacuum extraction, prolonged delivery stage II, oxytocin labor induction, premature fetal expression according to Kristeller, and previous shoulder dystocia in macrosomatic children. The sequels of shoulder dystocia and obstetric maneuvers for incarcerated shoulder release include clavicular fracture, brachial plexus lesions, sternocleidomastoid muscle distension with or without hematoma, diaphragmatic paralysis, Horner's syndrome, peripartal asphyxia and consequential cerebral lesions (cerebral palsy), and peripartal death. Maternal complications due to shoulder dystocia are postpartal hemorrhage, cervical and vaginal lacerations, frequent infections during the puerperium, symphysiolysis and rupture of the uterus, and secondary cesarean section with related complications due to unsuccessful obstetric procedures or as continuation of Zavanelli's maneuver. McRoberts' maneuver (or Gaskin maneuver) is recommended as the initial procedure for shoulder release in case of shoulder dystocia. If it fails, other obstetric procedures such as Resnik's suprapubic pressure and Woods' grip with posteriorly placed arm release should be used, always with gross lateral episiotomy. The performance of all these obstetric procedures requires skilfull and highly experienced obstetrician and obstetric team as a whole.
Topics: Delivery, Obstetric; Dystocia; Female; Humans; Infant, Newborn; Labor Presentation; Pregnancy; Risk Factors; Shoulder
PubMed: 12596626
DOI: No ID Found -
Equine Veterinary Journal May 1999
Topics: Animals; Cesarean Section; Dystocia; Female; Horse Diseases; Horses; Pregnancy; Pregnancy Outcome
PubMed: 10402126
DOI: 10.1111/j.2042-3306.1999.tb03167.x -
Obstetrics and Gynecology Feb 2023
Topics: Pregnancy; Female; Humans; Shoulder Dystocia; Delivery, Obstetric; Dystocia; Shoulder
PubMed: 36657150
DOI: 10.1097/AOG.0000000000005076 -
Scientific Reports Feb 2023Our aim was to identify factors associated with shoulder dystocia following an attempted operative vaginal delivery (aOVD) in a prospective cohort study and to evaluate...
Our aim was to identify factors associated with shoulder dystocia following an attempted operative vaginal delivery (aOVD) in a prospective cohort study and to evaluate whether these factors can be used to accurately predict shoulder dystocia by building a score of shoulder dystocia risk. This was a planned secondary analysis of a prospective cohort study of deliveries with aOVD at term from 2008-2013. Cases were defined as women with shoulder dystocia following an aOVD defined as a delivery that requires additional obstetric maneuvers following failure of gentle downward traction on the fetal head to effect delivery of the shoulders. Multivariate logistic regression analyses were performed to determine risk factors for shoulder dystocia. Shoulder dystocia occurred in 57 (2.7%) of the 2118 women included. In the whole cohort, women with shoulder dystocia more often had a history of shoulder dystocia (3.5% vs. 0.2%, p = 0.01), and there was a significant interaction between aOVD and gestational age and the duration of the second stage of labor: women with shoulder dystocia more often had a gestational age > 40 weeks and a second stage of labor longer than 3 h specifically for midpelvic aOVD. In multivariable analysis, a history of shoulder dystocia was the only factor independently associated with shoulder dystocia following aOVD (aOR 27.00, 95% CI 4.10-178.00). The AUC for the receiver operating characteristic curve generated using a multivariate model with term interaction with head station was 0.70 (95% CI 0.62-0.77). The model failed to accurately predict shoulder dystocia.
Topics: Pregnancy; Humans; Female; Infant; Shoulder Dystocia; Dystocia; Prospective Studies; Delivery, Obstetric; Labor, Obstetric; Risk Factors; Shoulder; Retrospective Studies
PubMed: 36792626
DOI: 10.1038/s41598-023-29109-7 -
Clinical Obstetrics and Gynecology Mar 1987Women have always used different positions to make labor more comfortable and, when allowed, spontaneously change position numerous times during labor and birth. The... (Review)
Review
Women have always used different positions to make labor more comfortable and, when allowed, spontaneously change position numerous times during labor and birth. The positions they choose, while dictated by comfort, frequently prove to be beneficial in promoting labor progress. For 50 years, the value of mobility and position change received little attention, but recent research and advances in the design of birthing equipment indicate that maternal positioning provides a valuable, noninvasive, and acceptable intervention. This paper reviewed six mechanisms by which dystocia may be prevented or corrected through the use of maternal positioning.
Topics: Animals; Dystocia; Female; Humans; Labor Presentation; Lordosis; Posture; Pregnancy
PubMed: 3555921
DOI: 10.1097/00003081-198703000-00012 -
The Journal of Maternal-fetal &... Sep 2020Shoulder dystocia is an obstetric emergency, occurring in 0.2-3% of vaginal deliveries. Research has mainly focused on the neonatal morbidity arising from shoulder...
Shoulder dystocia is an obstetric emergency, occurring in 0.2-3% of vaginal deliveries. Research has mainly focused on the neonatal morbidity arising from shoulder dystocia, such as brachial plexus injury and hypoxic-ischemic encephalopathy. Maternal morbidity is thought to be increased with shoulder dystocia though is much less commonly reported. Obstetric anal sphincter injury remains the leading cause of fecal incontinence in women and shares several antenatal and intrapartum risk factors with shoulder dystocia. The aim of this study was to identify risk factors for sphincter injury associated with shoulder dystocia. This retrospective analysis included all cases of shoulder dystocia from 2008 to 2017 in a single unit in North-East Ireland. Maternal characteristics and delivery outcomes were analyzed. Two groups were compared, those with and without anal sphincter injury in our shoulder dystocia cohort and those with and without shoulder dystocia, regardless of sphincter injury. Univariate and multivariate logistic regression models were used to examine risk factors for sphincter injury. There were 24,159 singleton cephalic vaginal deliveries over the study period, with 495 cases of shoulder dystocia, giving an incidence of 2.1% (495/24 159). The rate of anal sphincter injury in those with shoulder dystocia was 4.4% (22/495), with 7.6% (12/158) in nulliparas, and 3.0% (10/337) among multiparas. Women with sphincter damage were more likely to be nulliparous than those with an intact sphincter (54.5% [12/22] vs. 30.9% [146/473]; = .036) and have an operative vaginal delivery (72.7% [16/22] vs. 39.1% [185/473]; = .004). Episiotomy was more common in those with a sphincter injury (68.2% [15/22] vs. 37.0% [175/473]; = .007). On univariate regression analysis, nulliparity (OR 2.69) and operative vaginal delivery (OR 4.15) were associated with sphincter injury. No risk factors were identified on multivariate regression analysis. In our population, the risk of anal sphincter injury with shoulder dystocia is 4.4%. Risk factors include nulliparity and operative vaginal delivery. After controlling for other factors, these associations became nonsignificant. Further research into sphincter injury at shoulder dystocia is warranted.
Topics: Anal Canal; Delivery, Obstetric; Dystocia; Episiotomy; Female; Humans; Infant, Newborn; Pregnancy; Retrospective Studies; Risk Factors; Shoulder; Shoulder Dystocia
PubMed: 30696310
DOI: 10.1080/14767058.2019.1569617 -
Journal of Medical Primatology Apr 2023A 14-year-old female black and white colobus monkey (Colobus guereza) presented in labor with fetal arms visible protruding from the vulva. Manual manipulation for...
A 14-year-old female black and white colobus monkey (Colobus guereza) presented in labor with fetal arms visible protruding from the vulva. Manual manipulation for assisted delivery of the fetus was unsuccessful. Radiographs identified a large fetal skull and hysterotomy was required with ovariohysterectomy elected to follow. The fetus was confirmed to be deceased during hysterotomy, but the dam recovered from the procedure uneventfully. The detailed description of the anesthesia and surgical procedure in this case may aid other clinicians when presented with similar dystocia cases in this species.
Topics: Female; Animals; Colobus; Dystocia
PubMed: 36420921
DOI: 10.1111/jmp.12628 -
Zeitschrift Fur Geburtshilfe Und... Oct 2020Fetal shoulder dystocia (FSD) is an unpredictable and critical obstetric intrapartum emergency, where an objective problem is the relationship between the mother's...
Fetal shoulder dystocia (FSD) is an unpredictable and critical obstetric intrapartum emergency, where an objective problem is the relationship between the mother's pelvis and the child, i. e., an anthropometric disorder of delivery mechanics and dynamics. It is evident that the need to perform other maneuvers indicates the severity of FSD, which in turn correlates with the consequent iatrogenic injury of the fetus and/or mother. FSD is certainly the most controversial forensic obstetric problem, with the most disputes, compensation for damages due to peripartum injury to the child and/or mother, pain suffered, the need for someone else's care, and permanent disability. Suboptimal procedures and inadequate documentation are factors of forensic risk and subsequent litigations. Prevention of FSD is generally not possible, although good antenatal care can sometimes exclude risky cases of FSD, and some rare, chronic intrauterine disorders can result in orthopedic and neurological sequelae, which is especially important in forensic analysis. Because FSD is largely impossible to predict, it must be viewed as an intrapartum acceptable risk. During childbirth, FSD may compromise the safety of the mother and unborn child, therefore education and skills acquisition are necessary for obstetric work. Risk control, proper procedures, and proper documentation, along with good communication with the pregnant women and their families, significantly reduce litigation procedures.
Topics: Child; Delivery, Obstetric; Dystocia; Female; Humans; Pregnancy; Prenatal Care; Risk Factors; Shoulder Dystocia
PubMed: 32575127
DOI: 10.1055/a-1192-7254