[Fetal shoulder girdle dystocia during labor]

Abstract

Shoulder dystocia occurred in 98 women (0.9%) among 10,695 deliveries during the period of 1986-1988. The most frequent cause was overweight and strangulated umbilical cord. The following maneuvers were used: pressure on the uterine fundus, strong flexion of legs (maneuver of Knebel-Macroberts-Korokawa) and in 12 cases--extraction of the posterior hand. The head should be rotated to the opposite thigh of the parturient in cases with incorrect rotation of the head--the most frequent cause for low shoulder dystocia. Prophylactic measures are of special significance: cesarean section in women with large fetus, estimated by ultrasound, or with fetus with thoracic diameter larger than biparietal diameter with 1.5 sm. The delivery should be managed by the most experienced obstetricians and should not be protracted or precipitate without indications.