Shoulder dystocia. A complication of fetal macrosomia and prolonged second stage of labor with midpelvic delivery.

摘要: Shoulder dystocia is an infrequently encountered obstetric emergency varying in incidence from 0.15 to 0.60% of all deliveries. Previously identified risk factors include maternal obesity, previous infants weighing greater than 4 kg, diabetes, and fetal macrosomia (greater kg). To evaluate the role prolonged second stage labor (PSS) as a warning sign for shoulder dystocia, 9864 deliveries at LAC-USC Women's Hospital were retrospectively reviewed. Ninety percent delivered vaginally 4.89% had PSS with midpelvic delivery. occurred 0.37% vertex vaginal In absence delivery, was 0.16%. However, 4.57% (P less 0.01). Infants excess kg increased compared kg. When delivery attempted, 21% kg; 8% failed All dystocias after use vacuum extractor. Immediate neonatal injury apparent 47% There no or deaths related during study period.