At

the
delivery
At the delivery
room...
room...

Shoulder Dystocia

Shoulder Dystocia
the situation during delivery
when the babys shoulder
becomes stuck behind the
mothers pubic bone

Shoulder Dystocia
uncommon obstetric
complication of cephalic vaginal
deliveries during which the
fetal shoulders has emerged
from the mothers introitus.
occurs when one or both
shoulders becomes impacted
against the bones of the
maternal pelvis

RISK FACTORS Of
Shoulder Dystocia
1. CEPHALOPELVIC DISPROPORTION (CPD)
. fetal shoulder dimensions are too large or the maternal pelvis is too narrow
to permit shoulder rotation to the oblique pelvic diameter, persistent
anteroposterior orientation of the fetal shoulders may result in the anterior
shoulder being obstructed behind the symphysis pubis
2. MECHANICAL REASONS
. fetal heads cardinal movements of descent, flexion, and internal rotation
within the bony pelvis, the shoulders descend to reach the pelvic inlet.
. heads subsequent extension, delivery, and external rotation, prior to final
expulsion

RISK FACTORS OF
Shoulder Dystocia
3. FETAL MACROSOMIA

4. GESTATIONAL DIABETES
5. EXCESSIVE WEIGHT GAIN (>35 LB) DURING PREGNANCY
6. OBESITY

6. POSTTERM PREGNANCY
7. PROLONGED LABOR
8. OPERATIVE VAGINAL DELIVERY ( FORCEPS AND VACUUM)

Shoulder Dystocia
is an
OBSTETRIC EMERGENCY

MANAGEMENT OF
SHOULDER DYSTOCIA
Timely management of shoulder dystocia requires prompt
recognition. The attendant health care provider should routinely
observe for:
difficulty with delivery of the face and chin
the head remaining tightly applied to the vulva or even
retracting (turtle-neck sign)
failure of restitution of the fetal head
failure of the shoulders to descend.