Shoulder dystocia: anticipation and outcome

Shoulder dystocia is a serious obstetric emergency with several cases of permanent disability and fetal deaths each year. Ninety-eight cases of shoulder dystocia, an incidence of 0.45%, occurred in Farwania Hospital, Kuwait during 1985-1987. Of these 54.1% had one or more birth trauma. The perinatal mortality rate was 71.4 per thousand, with a considerable increase in the rate of maternal complications. Macrosomia, maternal diabetes, augmentation and induction of labor, vacuum extraction, post-term and malposition, were identified risk factors. We found that if all babies weighing greater than or equal to 4.5 kg are delivered by cesarean section, dystocia can be significantly reduced.