Identification of Neonates at Risk for Shoulder Dystocia

Description

Shoulder dystocia refers to an abnormal vaginal delivery with the arrest related to the shoulder of the fetus. Acker et al identified several risk factors for shoulder dystocia in neonates. A fetus with a significant risk may benefit from Cesarean section.

Complications of shoulder dystocia:

(1) fracture of the upper extremity

(2) brachial plexus injury

(3) respiratory difficulty, including asphyxia

(4) rarely death

Risk factors identified:

(1) presence of diabetes mellitus

(2) high fetal weight

(3) abnormal labor pattern

Patient Group	Fetal Weight	Labor Pattern	Risk of Dystocia
diabetic	< 4,000 gram		3.7%
	>= 4,000 grams		30.6%
nondiabetic	< 4,000 grams		1.1%
	4,000 – 4,499 grams		10.0%
	>= 4,500 grams	normal	17.3%
	>= 4,500 grams	precipitate	26.1%
	>= 4,5000 grams	prolonged latent phase	35.3%
	>= 4,500 grams	protraction disorder	22.6%
	>= 4,500 grams	arrest disorder	55.0%

after Figure 1, page 767

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Description

Specialty

ICD-10