Shoulder dystocia occurs during the delivery of a child. When the crown of the head begins to proceed out of the vaginal cavity, the shoulders of the child will get caught behind the mother’s pubic bone and cause this medical condition. The problem with diagnosing shoulder dystocia is that there isn’t an official definition in place. Sometimes a diagnosis occurs in as little as 60 seconds. In other instances, if the situation resolves itself, the condition will never be diagnosed.
Facts About Shoulder Dystocia
1. The incidence of shoulder dystocia is generally reported to be between 0.5% and 1.5%.
2. Independent observers during a delivery have noted that shoulder dystocia is not noted in up to 50% of the times that it occurs.
3. The reported incidence ranges from 0.6% to 3% among vaginal deliveries of fetuses in the vertex presentation.
4. The percentage of very large babies in one study has gone up 300% between 1970 and 1988.
5. When newborns weigh around 9 pounds at birth, the incidence rate of this medical condition rises up to 9%.
6. Shoulder dystocia occurs with equal frequency in primigravid and multigravid women.
7. Diabetes mellitus confers a risk of shoulder dystoocia which is 6x greater than that of the normal population
8. The single most common risk factor for shoulder dystocia is the use of a vacuum extractor or forceps during delivery.
9. Most cases of shoulder dystocia occur in fetuses of normal birth weight and are unanticipated, limiting the clinical usefulness of risk-factor identification.
10. Postpartum hemorrhage occurs in 11% of the cases of shoulder dystocia that have been noted.
11. 3.8%. That’s the number of fourth degree laceration instances that have been noted when shoulder dystocia occurs.
12. Palsies occur in up to 15% of the newborns that experience shoulder dystocia, although most will resolve themselves by their first birthday. Fewer than 1 in 10 palsies that occur from this condition will result in a permanent injury.
13. In the UK, neonatal brachial plexus injury is the single most common cause for litigation related to SD
14. Since the inception of the NHS Litigation Authority in 1995 it has received around 555 claims, in relation to SD, with an approximate value of £189.4 million.
15. 12%. That’s the percentage of women who will have a second instance of shoulder dystocia after experiencing it with a previous child.
16. One of the most successful methods of resolving shoulder dystocia is called McRobet’s maneuver and its success rate has been reported as high as 90%.
17. Without any interventions taking place at all within the first 5 minutes of the condition happening, up to 1 in 2 children may experience a fatal injury during birth.
There is a suspicion in the shoulder dystocia statistics that it is highly underreported by hospitals. The fear is that if the incident is noted on the charts that it can be used as evidence against the hospital should a malpractice lawsuit occur. Certain women are at a higher risk of experiencing this condition as well, which means a true incidence rate cannot generally be determined. Women with diabetes or babies that are above average in size will experience a greater risk of experiencing this condition.
Are There Ways To Limit the Risks of Shoulder Dystocia?
Researchers have consistently found that larger women tend to have a higher risk of shoulder dystocia occurring during a natural delivery. This is because larger women tend to have larger babies and this creates a higher risk automatically. Larger women also have a greater chance of having non-diagnosed diabetes present, which greatly enhances the risk.
Many of the risk factors are not known right now, however, so the best preventative measures are to eat a healthy diet and exercise regularly according to a doctor’s instructions. If diabetes is present, then expecting mothers should work control it according to the treatment plan that is in place. Mothers who have had large children in the past should also have regular check-ups to determine if there will be increased risk factors for shoulder dystocia as well.
With shoulder dystocia, the good news is that most cases of it do not result in any permanent damage to the mother or the newborn. If the health risks can be properly managed and the proper equipment is used for the delivery, then there is a good chance that a successful natural birth can take place.