Shoulder Dystocia

Shoulder dystocia, defined as failure of the shoulders to deliver following the head, is an obstetric emergency. The incidence varies from 0.6% to 1.4% of all vaginal deliveries. Up to 30% of shoulder dystocias can result in brachial plexus injury; many fewer sustain serious asphyxia or death. Most commonly, size discrepancy secondary to fetal macrosomia is associated with difficult shoulder delivery. Causal factors of macrosomia include maternal diabetes, postdates gestation, and obesity. The fetus of the diabetic gravida may also have disproportionately large shoulders and body size compared with the head.

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