Shoulder Dystocia
(Diseases)
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What is Shoulder Dystocia?
Shoulder dystocia occurs when one or both of the baby’s shoulders become stuck in the pelvis during delivery.
What Are the Symptoms of Shoulder Dystocia?
Obstetricians typically identify shoulder dystocia only after the baby’s head is delivered. It becomes apparent when the baby’s head emerges and then retracts against the perineum (the area between the vagina and rectum).
- What Are the Causes of Shoulder Dystocia?
- Shoulder dystocia happens when one or both of the baby’s shoulders get stuck behind the mother’s pubic bone during delivery. The following factors may contribute to shoulder dystocia:
- Fetal macrosomia.
Abnormal fetal positioning.
A pelvis that is too small.
- How Is Shoulder Dystocia Diagnosed?
- An obstetrician may diagnose shoulder dystocia if the following three conditions are met:
- The baby’s head is delivered, but the shoulders cannot be delivered despite maternal effort.
More than one minute passes between the delivery of the head and the rest of the body.
Medical intervention is needed to deliver the baby.
- How Is Shoulder Dystocia Treated?
- Treatment depends on the situation and may include:
- Changing the mother’s position to widen the pelvis.
- Clavicle fracture: The doctor may intentionally break the baby’s collarbone to free the shoulders.
Zavanelli maneuver: The doctor repositions the baby’s head back into the uterus to perform a cesarean section.
Symphysiotomy: The doctor makes a cut in the cartilage between the pubic bones to enlarge the pelvic opening.
- How CanShoulderDystociaBePrevented?
- Shoulder dystocia cannot be completely prevented, but the following steps may help reduce the risk:
- Manage diabetes, as gestational diabetes increases the risk of fetal overgrowth.
- Maintain a healthy weight during pregnancy.
- Discuss labor induction with your doctor.
If you pass your due date, contact your healthcare provider.
Discuss the possibility of cesarean delivery with your doctor.
- What Are the Complications of Shoulder Dystocia?
- For the mother:
- Severe postpartumbleeding.
- Serious perineal tears.
- Rectovaginal fistula: an abnormal connection between the vagina and rectum.
Uterine rupture during labor.
- Separation of the pubic bones.
- For the baby:
- Brachial plexus palsy: Damage to the nerves extending from the spinal cord through the neck and down the arm, leading to weakness or paralysis on the affected side.
- Fractures of the baby’s clavicle and/or humerus.
Horner’s syndrome: A rare condition affecting the baby’s eyes and face.
Compressed umbilical cord: The cord may become trapped between the baby’s arm and the mother’s pelvic bone.
When Should You See a Doctor?
Shoulder dystocia cannot be detected before labor. It is only recognized during delivery by the medical team.
Frequently Asked Questions:
