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Review
. 2018 Nov 9:10:723-732.
doi: 10.2147/IJWH.S175088. eCollection 2018.

Shoulder dystocia: incidence, mechanisms, and management strategies

Savas Menticoglou  1
Affiliations
Review

Shoulder dystocia: incidence, mechanisms, and management strategies

Savas Menticoglou. Int J Womens Health. .

Abstract

Shoulder dystocia can lead to death or brain damage for the baby. Traction on the head can damage the brachial plexus. The diagnosis should be made when the mother cannot push the shoulders out with her own efforts with the next contraction after delivery of the head. There should be no traction on the head to diagnose shoulder dystocia. McRoberts' position is acceptable but it should not be accompanied by any traction on the head. If the posterior shoulder is in the sacral hollow then the best approach is to use posterior axillary traction to deliver the posterior shoulder and arm. If both shoulders are above the pelvic brim, the posterior arm should be brought down with Jacquemier's maneuver. If that fails, cephalic replacement or symphysiotomy is the next step. After shoulder dystocia is resolved, one should wait 1 minute or so to allow placental blood to return to the baby before cutting the umbilical cord.

Keywords: Jacquemier’s maneuver; brachial plexus injury; neonatal resuscitation; shoulder dystocia; symphysiotomy.

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Conflict of interest statement

Disclosure The author reports no conflict of interest in this work. The author would like to disclose that as the patients have been lost to follow-up, patient written informed consent for publication of these case details was not possible. The details have been sufficiently anonymized as not to cause harm to the patient.

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References

    1. Verspyck E, Goffinet F, Hellot MF, Milliez J, Marpeau L. Newborn shoulder width: a prospective study of 2222 consecutive measurements. Br J Obstet Gynaecol. 1999;106(6):589–593. - PubMed
    1. Youssef AEA, Amin AF, Khalaf M, Khalaf MS, Ali MK, Abbas AM. Fetal biacromial diameter as a new ultrasound measure for prediction of macrosomia in term pregnancy: a prospective observational study. J Matern Fetal Neonatal Med. 2018;7:1–6. - PubMed
    1. Borell U, Fernstrom I. Radiographic studies of the rotation of the fostal shoulders during labour. Acta Obstet Gynecol Scand. 1958;37(1):54–61. - PubMed
    1. Sreekanth R, Thomas BP. Human evolution: the real cause for birth palsy. West Indian Med J. 2015;64(4):424–428. - PMC - PubMed
    1. Spong CY, Beall M, Rodrigues D, Ross MG. An objective definition of shoulder dystocia: prolonged head-to-body delivery intervals and/or the use of ancillary obstetric maneuvers. Obstet Gynecol. 1995;86(3):433–436. - PubMed