Related Experiment Video
Updated: May 20, 2026
Development of a Neonatal Rat Model for Brachial Plexus Birth Injury
Published on: March 27, 2026
Outcomes associated with a structured prenatal counseling program for shoulder dystocia with brachial plexus injury
Mary Veronica Daly1, Christina Bender, Kathryn E Townsend
1Lifeline Medical Associates, Atlantic Health System, Morristown, NJ, USA.
Insights
A new program effectively identified high-risk pregnancies for shoulder dystocia, significantly reducing shoulder dystocia rates by over 50% without increasing cesarean delivery rates.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Perinatal Outcomes
Background:
- Shoulder dystocia is a significant obstetric emergency associated with brachial plexus injury.
- Identifying high-risk pregnancies is crucial for proactive management and improved outcomes.
Purpose of the Study:
- To evaluate the effectiveness of a novel program designed to identify patients at high risk for shoulder dystocia with brachial plexus injury.
- To assess the impact of this program on shoulder dystocia and cesarean delivery rates.
Main Methods:
- A prospective study comparing outcomes in deliveries managed with a new risk-identification program versus those without.
- The program utilized a checklist of risk factors and a multifactorial algorithm to stratify risk.
- Data on cesarean delivery and shoulder dystocia rates were analyzed for 8,767 deliveries in the program group and 11,958 in the control group.
Main Results:
- Key risk factors were identified in 12.2% of mothers, with 0.46% classified as high-risk.
- Shoulder dystocia rates decreased by 56.8% in the program group (1.74% to 0.75%, P = .002).
- Cesarean delivery rates remained stable (21.2% to 20.8%, P = .57), and no significant changes were observed in the control group.
Conclusions:
- The novel risk-identification program significantly reduced shoulder dystocia rates by over 50%.
- The program achieved these improved outcomes without an increase in the rate of primary cesarean deliveries.
- This intervention demonstrates a successful strategy for mitigating shoulder dystocia complications.
Objective:
We examined outcomes that were associated with a novel program to identify patients who are at high risk for shoulder dystocia with brachial plexus injury.
Study Design:
The program included a checklist of key risk factors and a multifactorial algorithm to estimate risk of shoulder dystocia with brachial plexus injury. We examined rates of cesarean delivery and shoulder dystocia in 8767 deliveries by clinicians who were enrolled in the program and in 11,958 patients of clinicians with no access to the program.
Results:
Key risk factors were identified in 1071 of 8767 mothers (12.2%), of whom 40 of 8767 women (0.46%) had results in the high-risk category. The rate of primary cesarean delivery rate was stable (21.2-20.8%; P = .57). Shoulder dystocia rates fell by 56.8% (1.74-0.75%; P = .002). The rates of shoulder dystocia and cesarean birth showed no changes in the group with no access to the program.
Conclusion:
With the introduction of this program, overall shoulder dystocia rates fell by more than one-half with no increase in the primary cesarean delivery rate.
