Schulterdystokie – Risikofaktoren und Hinweiszeichen

Hitschold, T.; Grewe, J.

doi:10.1055/s-2008-1076978

Cited by 3 publications

(1 citation statement)

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“…Around half of all cases with shoulder dystocia occur with infants who weigh less than 4000 g (Berle et al: 44 % [3]; Stein et al: 40.5 % [4]). Numerous risk factors for shoulder dystocia have been reported in the literature [1,[3][4][5][6]. They include maternal risk factors such as obesity (BMI > 30), maternal weight gain of more than 15 kg during pregnancy, diabetes mellitus, multiparity, late-term birth (more than 7 days late), induction of labour, shoulder dystocia at anamnesis, and pelvic anomalies.…”

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Abdominal Access for Shoulder Dystocia as a Last Resort - a Case Report

Enekwe

Rothmund

Uhl

2012

Geburtsh Frauenheilk

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Shoulder dystocia is the term used to describe failure to progress in labour after the head has been delivered due to insufficient rotation of the shoulders. It is unpredictable and cannot be prevented by the midwife or the obstetrician. We report here on a severe case of shoulder dystocia, where delivery of the shoulder was finally achieved through direct pressure on the anterior shoulder after laparotomy and uterotomy with concurrent vaginal Woods screw manoeuvre and was followed by vaginal delivery. The patient presented risk factors like maternal obesity and administration of labour-inducing drugs. After different manoeuvres like McRoberts manoeuvre and several manoeuvres for internal rotation were carried out unsuccessfully, an emergency laparotomy was performed. The newborn was in need for reanimation and artifical ventilation postpartum but recovered fast during the following days. An Erb?s palsy of the posterior arm improved during the hospital stay. The German Guideline of the DGGG 8 recommends a risk management plan and regular training to all birth attendants for obstetric clinics. Beside the vaginal manoeuvres one should have at least theoretical expertise in operative manoeuvres to be able to perform them in emergency cases.

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