Risk of recurrent shoulder dystocia: are we any closer to prediction?

Abstract

Recurrent shoulder dystocia is an unpredictable obstetric complication with potentially devastating consequences. Individual assessment and thorough counselling should be offered to women contemplating a subsequent planned vaginal birth with specific attention paid to those women where the estimated birthweight is >4000 g or greater than in the index pregnancy.

Maneuvering Through a Birth Complicated by Shoulder Dystocia

“…Despite the highly unpredictable nature of shoulder dystocia, because of the severity of injury it is one of the most litigated complications of childbirth in the United States. 3,5 The risk of legal liability in the United States when caring for women and newborns has increased over the past 20 years. 8 It is reported that 15% of certified nurse-midwives and certified midwives (CNMs/CMs) and 91% of obstetriciangynecologists have been named in lawsuits.…”

“…22 There is limited research regarding these effects, and more study is needed to quantify the magnitude of this problem. 3,8,31 Clinicians may experience a condition called secondary traumatic stress that is similar to PTSD. Secondary traumatic stress occurs as a result of the emotional distress that arises from the desire to help someone who is traumatized or suffering.…”

“…Shoulder dystocia occurs in approximately 1% of all vaginal births. [1][2][3] Neonatal complications resulting from shoulder dystocia include brachial plexus injury, fractures of the clavicle or humerus, hypoxemic ischemic injury with short-term and long-term effects, and death. [2][3][4][5] Maternal complications include postpartum hemorrhage, anal sphincter injury, and deep lacerations of vagina and perineum.…”

“…[1][2][3] Neonatal complications resulting from shoulder dystocia include brachial plexus injury, fractures of the clavicle or humerus, hypoxemic ischemic injury with short-term and long-term effects, and death. [2][3][4][5] Maternal complications include postpartum hemorrhage, anal sphincter injury, and deep lacerations of vagina and perineum. [2][3][4][5][6] Shoulder dystocia may have profound psychological effects on the woman and intrapartum care provider and has legal implications.…”

“…[2][3][4][5] Maternal complications include postpartum hemorrhage, anal sphincter injury, and deep lacerations of vagina and perineum. [2][3][4][5][6] Shoulder dystocia may have profound psychological effects on the woman and intrapartum care provider and has legal implications. 5,[7][8][9] The cost burden associated with shoulder dystocia includes increased expense associated with treating short-and long-term injury resulting from the shoulder dystocia as well as legal costs to both the intrapartum care provider and the woman and her family.…”