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Obstet Gynecol Clin North Am ; 40(1): 59-67, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23466137

ABSTRACT

The frequency of shoulder dystocia in different reports has varied, ranging 0.2-3% of all vaginal deliveries. Once a shoulder dystocia occurs, even if all actions are appropriately taken, there is an increased frequency of complications, including third- or fourth-degree perineal lacerations, postpartum hemorrhage, and neonatal brachial plexus palsies. Health care providers have a poor ability to predict shoulder dystocia for most patients and there remains no commonly accepted model to accurately predict this obstetric emergency. Consequently, optimal management of shoulder dystocia requires appropriate management at the time it occurs. Multiple investigators have attempted to enhance care of shoulder dystocia by utilizing protocols and simulation training.


Subject(s)
Birth Injuries/diagnosis , Brachial Plexus Neuropathies/diagnosis , Delivery, Obstetric/adverse effects , Delivery, Obstetric/methods , Dystocia/diagnosis , Shoulder , Birth Injuries/etiology , Birth Injuries/mortality , Birth Injuries/therapy , Brachial Plexus/injuries , Brachial Plexus Neuropathies/etiology , Brachial Plexus Neuropathies/mortality , Brachial Plexus Neuropathies/therapy , Clavicle/embryology , Clavicle/injuries , Dystocia/mortality , Dystocia/therapy , Female , Fractures, Bone/diagnosis , Fractures, Bone/embryology , Humans , Humeral Fractures/diagnosis , Humeral Fractures/embryology , North America/epidemiology , Patient Positioning , Perineum/injuries , Postpartum Hemorrhage/etiology , Postpartum Hemorrhage/mortality , Postpartum Hemorrhage/therapy , Practice Guidelines as Topic , Predictive Value of Tests , Pregnancy , Tocolytic Agents
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