Obstetric maneuvers for shoulder dystocia

Iffy, Leslie; Ganesh, Vijaya; Gittens, Lisa

doi:10.1016/s0002-9378(98)60166-6

Cited by 8 publications

(3 citation statements)

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“…Indeed, waiting for a contraction after the head in all vaginal deliveries has been shown to markedly reduce shoulder dystocia incidence, as well be clinically beneficial for the fetus. [25][26][27][28][29] The natural motion of the fetus during the second stage of labor and ultimate delivery of the trunk is accomplished from an engineering perspective by uterine forces and by clinician-applied guidance and or traction. Qualitative and FIGURE 2.…”

Section: Human Birth and The Pathogenesis Of Shoulder Dystociamentioning

confidence: 99%

On the Mechanical Aspects of Shoulder Dystocia and Birth Injury

Allen

2007

Clinical Obstetrics &Amp; Gynecology

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This article presents objective evidence about shoulder dystocia and its associated mechanical injuries, namely clavicle fractures, and brachial plexus injuries. Specifically, the review focuses on the mechanical response of the fetus to forces applied to it or its anatomic components, including possible force thresholds for injury. This is followed by presenting the medical and engineering literature on the mechanical aspects of shoulder dystocia with emphasis on kinematics, the forces associated with labor and with traction forces associated with delivery. Finally, the paper discusses the mechanical characteristics of maternal and fetal maneuvers for shoulder dystocia and demonstrates how shoulder dystocia models can be used to train clinicians in the performance of maneuvers that stress the fetus the least. From a mechanical point of view, there are obstetric methods and training that can be employed to reduce the stresses induced by the fetus while alleviating shoulder dystocia, thereby reducing, but not eliminating, the risk of mechanical injury.

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Section: Human Birth and The Pathogenesis Of Shoulder Dystociamentioning

confidence: 99%

On the Mechanical Aspects of Shoulder Dystocia and Birth Injury

Allen

2007

Clinical Obstetrics &Amp; Gynecology

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“…Other alternatives are Zavanelli's maneuvre (6,25,98,99) and anterior symphysiotomy (96). With Zavanelli's maneuvre the fetal head is pushed back into the pelvis to permit delivery by cesarean section (25,98). The literature indicates that the procedure has a high success rate.…”

Section: Management Of Shoulder Dystociamentioning

confidence: 99%

Suspected big baby: a difficult clinical problem in obstetrics

Haram

Pirhonen

Bergsjø

2002

Acta Obstet Gynecol Scand

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“…Other alternatives are Zavanelli's maneuvre (6, 25, 98, 99) and anterior symphysiotomy (96). With Zavanelli's maneuvre the fetal head is pushed back into the pelvis to permit delivery by cesarean section (25, 98). The literature indicates that the procedure has a high success rate.…”

Section: Management Of Shoulder Dystociamentioning

confidence: 99%

Suspected big baby: a difficult clinical problem in obstetrics

Haram¹,

Pirhonen²,

Bergsjø³

2002

Acta Obstet Gynecol Scand

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Based on the literature, labor should not be induced in nondiabetic pregnancies. The best policy is to await spontaneous birth or to induce labor after 42 weeks completion. A great number of cesarean sections have to be performed to avoid a single case of plexus brachialis paresis resulting from a difficult shoulder delivery. Cesarean section should not be considered in nondiabetic pregnancies unless the estimated fetal weight is above 5000 g. In pregnancies complicated by diabetes mellitus there are reasons for selective induction of labor if macrosomia is suspected and for cesarean section if the calculated birth weight is above 4000 g. Each department should have a strategy to handle such a situation because the problem with the difficult shoulder delivery cannot be completely avoided. Different procedures of managing difficult shoulder delivery are described.

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Obstetric maneuvers for shoulder dystocia

Cited by 8 publications

References 0 publications

On the Mechanical Aspects of Shoulder Dystocia and Birth Injury

On the Mechanical Aspects of Shoulder Dystocia and Birth Injury

Suspected big baby: a difficult clinical problem in obstetrics

Suspected big baby: a difficult clinical problem in obstetrics

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