Predisposing Factors for Shoulder Dystocia-Related Birth Injuries: Causation Analysis

Iffy, Leslie; Apuzzio, Joseph J.; Raju, V S

doi:10.1007/978-1-59745-473-5_13

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…Taking into account the entire data base, including that used for the previous relevant publications [4,15,16,24], Table 6 Birth of ≥4000 g baby in the past 25…”

Section: Resultsmentioning

confidence: 99%

“…It can be roughly estimated from the earlier cited data that, among mothers of newborns belonging to this weight group, one-third are diabetic, one-third have borderline glucose tolerance and one-third are normal. Since almost one-half of all neonates who suffered shoulder dystocia related birth injuries belonged to the ≥4500 g weight group [4,24], the contribution of borderline glucose intolerance to such injuries may approach that of clinical diabetes itself. Thus, identification and attentive management of these by definition "non-diabetic" mothers is of considerable clinical importance.…”

Section: Discussionmentioning

confidence: 99%

“…Large fetal size is the end result of a process which often can be controlled. Yet it is a prominent cause of shoulder dystocia and its dire sequelae [1,2,9,12,15,24]. It has been estimated that a 250 g fetal weight increase approximately doubles the risk of shoulder dystocia related fetal damage [15,16].…”

Section: Discussionmentioning

confidence: 99%

“…(More than 90% of the records in the data base contained reference to this diagnosis.) [4,24]. Central nervous system injury, still demonstrable >6 B.…”

Section: Methodsmentioning

confidence: 99%

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Shoulder dystocia related fetal neurological injuries: the role of diabetic control

Iffy¹,

Brimacombe

Váradi³

et al. 2009

Open Medicine

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AbstractThe study explores the roles of routine prenatal diabetic screening and control in the occurrence of neurological birth injuries associated with shoulder dystocia. The investigation involved retrospective review of 226 medical records that contained information about the antenatal events in cases that resulted in permanent neonatal injuries following arrest of the shoulders at delivery. Close attention was paid to diabetic screening and management of mothers with evidence of glucose intolerance. Analysis of the records revealed that one-third of all women, including those with predisposing factors, received no diabetic screening during pregnancy. The majority of confirmed diabetic patients were not treated adequately. Among babies of diabetic women, birth weights exceeding 4500 g were about 30-fold more frequent than among those with normal glucose tolerance. The data suggest that universal screening and rigid diabetic control, including mothers with borderline glucose tolerance, are effective measures for the prevention of excessive fetal growth and intrapartum complications deriving from it. If ignored, impaired maternal glucose tolerance may become a major predisposing factor for neurological birth injuries. It appears therefore that with routine screening for diabetic predisposition and effective control of gestational diabetes the risk of fetal damage can be reduced substantially.

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“…Taking into account the entire data base, including that used for the previous relevant publications [4,15,16,24], Table 6 Birth of ≥4000 g baby in the past 25…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…(More than 90% of the records in the data base contained reference to this diagnosis.) [4,24]. Central nervous system injury, still demonstrable >6 B.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Shoulder dystocia related fetal neurological injuries: the role of diabetic control

Iffy¹,

Brimacombe

Váradi³

et al. 2009

Open Medicine

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Intrapartum care and substandard care: juridical recommendations to reduce the risk of liability

Eggermont

2015

Arch Gynecol Obstet

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To reduce the liability rate of 66 %, several policy recommendations can be made. Respond to the first symptoms of obstetric complications (particularly placental abruption and uterine rupture). Secondly, respond to disturbing messages of the midwife concerning fetal distress and evaluate every deviation in fetal heart rate monitoring. Education concerning the interpretation of fetal monitoring is a must for every midwife and obstetrician. Use proper methods to monitor the heart rate to optimize the quality of the signal. The third recommendation is to be cautious about opting for a forceps/vacuum-assisted delivery, consider all circumstances. Consider the risk of failed instrumental delivery. And finally in relation to shoulder dystocia, recognize the risk factors by ordering further examinations to purchase a diagnosis.

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Prevention of shoulder dystocia related birth injuries: Myths and facts

Iffy¹

2014

WJOG

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Predisposing Factors for Shoulder Dystocia-Related Birth Injuries: Causation Analysis

Cited by 3 publications

References 18 publications

Shoulder dystocia related fetal neurological injuries: the role of diabetic control

Shoulder dystocia related fetal neurological injuries: the role of diabetic control

Intrapartum care and substandard care: juridical recommendations to reduce the risk of liability

Prevention of shoulder dystocia related birth injuries: Myths and facts

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