Related Experiment Videos
Shoulder dystocia: fifteen years' experience in Ramathibodi Hospital
R Roungsipragarn1, Y Herabutya
1Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Insights
Shoulder dystocia is rare but can have severe outcomes for mothers and infants. This study analyzed its incidence, contributing factors, and consequences, finding a low occurrence rate but significant risks like Erb
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Perinatal Medicine
Background:
- Shoulder dystocia, a rare obstetric emergency, poses significant risks to both mother and infant.
- Prompt identification and management are crucial to mitigate adverse outcomes.
Purpose of the Study:
- To determine the incidence of shoulder dystocia.
- To identify predisposing factors associated with shoulder dystocia.
- To evaluate the maternal and neonatal consequences of shoulder dystocia.
Main Methods:
- Retrospective review of all shoulder dystocia cases over a 15-year period (1982-1996).
- Analysis of delivery methods, birthweights, and maternal/neonatal complications.
Main Results:
- Incidence of shoulder dystocia was 1.6 per 10,000 deliveries.
- Vacuum extraction was used in 65% of shoulder dystocia cases.
- Two maternal postpartum hemorrhages occurred; six infants experienced Erb's palsy with full recovery.
Conclusions:
- Shoulder dystocia, though infrequent, necessitates careful monitoring due to potential severe complications.
- High rates of vacuum extraction in shoulder dystocia cases warrant further investigation.
- While Erb's palsy occurred, prompt intervention led to favorable infant outcomes in this cohort.
Abstract:
Although shoulder dystocia does not occur frequently the adverse effect to the patient and especially to infants can be catastrophic. The purpose of this study was to evaluate the incidence, the factors which may be related to or predispose to this condition and the consequence to the patients and their infants. All cases of shoulder dystocia which occurred during the fifteen year period from January 1982 to December 1996 were scrutinized. There were 17 cases of shoulder dystocia from a total of 109,923 deliveries giving the incidence of 1.6 per 10,000 deliveries. Of these 17 patients, 11 (65%) were delivered by vacuum extraction. Two patients had postpartum hemorrhage requiring blood transfusion. Infants' birthweights ranged between 3350 to 5160 grams. Erb's palsy occurred in 6 infants and all made full recovery subsequently.