Key clinical point: The risk for brachial plexus strain, injury, or tear can be minimized with prompt identification of shoulder dystocia (SD) accompanied by cessation of axial fetal head traction, while accurate obstetrical maneuvers can avoid permanent obstetric brachial palsy (OBP) or cerebral morbidity.
Major finding: SD was mostly unilateral anterior, with only 0.9% of cases diagnosed as the more difficult bilateral SD and 2% as recurrent SD. The majority (87.4%) of SD cases were managed by McRobert’s maneuver; the other management procedures included Barnum’s procedure (7.9%), Wood’s maneuver (3.9%), and Menticoglou procedure (0.4%). Only 7.5% of newborns were diagnosed with transient form of Duchenne Erb obstetrics brachioparesis (OBP), none with permanent OBP, and only 1 with cerebral morbidity.
Study details : This retrospective study analyzed the data of 45,687 singleton deliveries (vaginal deliveries, 78.9%; cesarean sections, 21.1%). Overall, 0.7% of vaginally delivered neonates had fetal SD .
Disclosures: No source of funding was reported. The authors declared no conflicts of interest.
Source: Habek D et al. Obstetrics injuries during shoulder dystocia in a tertiary perinatal center. Eur J Obstet Gynecol Reprod Biol. 2022;278:33-37 (Sep 10). Doi: 10.1016/j.ejogrb.2022.09.009