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Recurrence rate of shoulder dystocia
D F Lewis1, R C Raymond, M B Perkins
1Department of Obstetrics and Gynecology, Louisiana State University Medical Center, Shreveport 71130-3932, USA.
Objective:
Shoulder dystocia continues to be a major complication of obstetrics, and several factors have been identified to help predict its occurrence. A previous shoulder dystocia is one of the risk factors. However, the recurrence rate is unknown. The purpose of this study is to report the recurrence rate of shoulder dystocia.
Study Design:
Our obstetric database was used to identify all vaginal deliveries between January 1983 through December 1992. A subset of vaginal deliveries complicated by shoulder dystocia was selected from this database. These records were reviewed to identify subsequent pregnancies, outcomes, risk factors, and demographic data.
Results:
During the study period there were 37,465 total vaginal deliveries, with shoulder dystocia complicating 747 (overall rate 2%). Of these 747 cases, 101 patients had 123 subsequent vaginal deliveries, with shoulder dystocia complicating 17 of these pregnancies (13.8% recurrence rate, p < 0.0001). Comparisons were made between those patients with recurrent shoulder dystocia.
Conclusion:
Shoulder dystocia recurred at a rate approximately seven times higher than our primary rate. Whether patients with a history of shoulder dystocia should be offered an elective abdominal delivery requires further investigation.