Recurrent shoulder dystocia: is it predictable?

Abstract

Shoulder dystocia is an independent risk factor for recurrent shoulder dystocia. Deliveries in women with a history of shoulder dystocia are characterized by higher rates of operative delivery, prolonged second stage of labor and macrosomia.

Maternal prepregnancy obesity and the risk of shoulder dystocia: a meta‐analysis

“…Complications for the infant include brachial plexus injury and fractures, most commonly of the clavicle and humerus . It has been found that maternal factors including diabetes, multiparity, macrosomia and previous shoulder dystocia can increase the risk of shoulder dystocia …”

“…5 It has been found that maternal factors including diabetes, multiparity, macrosomia and previous shoulder dystocia can increase the risk of shoulder dystocia. 1,[7][8][9][10][11] Today, obesity is a worldwide public-health issue, with the rate of obesity increasing dramatically in the general population. According to data from the World Health Organization, 12 13% of adults aged 18 years and older (11% of men and 15% of women) are obese.…”

“…Shoulder dystocia is an obstetric outcome defined as difficulty in delivering an infant's shoulder, requiring additional manoeuvres when gentle downward traction of the fetal head is not enough to deliver the baby . Rates of shoulder dystocia reported in the literature vary widely, with estimates ranging from 0.1 to 2.4% of all births .…”

Population-Based Risk Factors for Shoulder Dystocia

“…In addition to these well-established risk factors, additional risk factors suggested in the literature include non-White race/ethnicity (Berggren, Boggess, Funk, & Stuebe, 2012;Cheng et al, 2006;Colombara, Soh, Menacho, Schiff, & Reed, 2011;Dodd et al, 2012), shorter height (Cheng et al, 2013;Gupta et al, 2010;Mazouni et al, 2006;Parantainen et al, 2014), multiparity (Gupta et al, 2010;Mazouni et al, 2006;Øverland et al, 2012, lack of prenatal care (Sheiner et al, 2006), history of previous shoulder dystocia (Kleitman, Feldman, Walfisch, Toledano, & Sheiner, 2016;Øverland, Spydslaug, Nielsen, & Eskild, 2009), prolonged labor (Gupta et al, 2010;Øverland et al, 2012, and induction of labor (Dodd et al, 2012;Øverland et al, 2012).…”

Once episiotomy, always episiotomy?

“…(2) Women who had episiotomy done before have a weaker scar tissue in this area which makes a preventive episiotomy more likely to be done to prevent perineal tears. (3) Women who give birth to higher birth weight infants, a known factor to make preventive episiotomy [14], tend to have heavier babies in the following pregnancies. (4) The pathophysiology of scar tissue created at the episiotomy site.…”