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Related Concept Videos

Muscles of the Shoulder01:23

Muscles of the Shoulder

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The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
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The anterior thoracic muscles include the serratus anterior, subclavius, and...
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Mouse Model of Surgical Uterine Injury and Subsequent Pregnancy Outcomes
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Shoulder Dystocia: Challenging Basic Assumptions.

Suneet P Chauhan1, Robert B Gherman2

  • 1Department of OB/GYN, Division of Maternal/Fetal Medicine, The University of Texas Health Sciences Center at Houston McGovern Medical School, UT Houston, 6431 Fannin, MSB 3.266, Houston, TX 77030, USA.

Obstetrics and Gynecology Clinics of North America
|September 19, 2022
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Summary

This review highlights significant knowledge gaps in managing shoulder dystocia, an obstetric emergency. Further research is needed to improve prevention, resolution, and understanding of long-term effects.

Keywords:
Hypoxic-ischemic injuryNeonatal acidemiaNeonatal brachial plexus palsyShoulder dystocia

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Area of Science:

  • Obstetrics
  • Emergency Medicine
  • Clinical Knowledge Gaps

Background:

  • Current knowledge on shoulder dystocia relies heavily on case reports and retrospective studies.
  • Empirical management protocols have been developed based on limited evidence.
  • Significant gaps exist in understanding prevention, resolution, and long-term sequelae of shoulder dystocia.

Purpose of the Study:

  • To identify and address critical knowledge gaps in the clinical understanding of shoulder dystocia.
  • To challenge existing recommendations for managing this obstetric emergency.
  • To stimulate further research into evidence-based practices for shoulder dystocia.

Main Methods:

  • Literature review and critical analysis of existing studies on shoulder dystocia.
  • Examination of current clinical recommendations and management protocols.
  • Identification of areas requiring further investigation and evidence generation.

Main Results:

  • Confirmed substantial deficiencies in the evidence base for shoulder dystocia prevention and management.
  • Highlighted controversies in current practices, including prophylactic cesarean delivery criteria and traction techniques.
  • Underscored the need for standardized training and clear definitions in shoulder dystocia management.

Conclusions:

  • Urgent need for high-quality research to fill knowledge gaps in shoulder dystocia.
  • Re-evaluation of current management strategies, including prophylactic interventions and operative techniques, is warranted.
  • Enhanced clinician training, potentially through simulation, is crucial for improving patient outcomes in shoulder dystocia cases.