Shoulder dystocia: the frightening case of a stuck baby
Shoulder dystocia is one of the most feared complications in obstetrics. Translated from Greek, Dystocia means "difficult childbirth." Shoulder dystocia injuries are caused when a baby's shoulders are unable to quickly and easily follow the delivery of the baby's head. Thus, the baby literally becomes stuck during birth and additional maneuvers are required to deliver the fetus after normal gentle downward traction has failed.
Complications resulting from shoulder dystocia during delivery can affect both the mother and infant. Postpartum hemorrhage and fourth-degree lacerations are the most common maternal complications. The most common fetal complication is nerve damage to the spine and shoulder (known as brachial plexus palsies) which may result in permanent injury and disfigurement to the baby.
Shoulder dystocia injuries can be devastating both physically and emotionally for all parties involved. The injuries may result in sizeable and unexpected medical expenses that may continue for years after the birth.
Sometimes shoulder dystocia occurs without warning. However, there are red flags that should signal a doctor to recommend a C-section instead of natural child birth.
One of the most common risk factors for shoulder dystocia is
suspected macrosomia in the fetus. The
term macrosomia is used to describe a newborn with an excessive birth weight. Other risk factors that may be present in
the mother are abnormal pelvic anatomy, gestational diabetes, post-dates
pregnancy, previous shoulder dystocia and short stature.
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