Shoulder Dystocia

Shoulder dystocia is an obstetric complication that occurs in approximately 30,000 deliveries in the U.S. each year. In this medical emergency is the head of the child in a position to clear the cervix, but the shoulders are affected after the mother's pelvis. This impaction can avoid a vaginal birth. In such cases, the baby's face will show what a sign of a turtle, where the head is known to be tightly pulled back on the vulva are. This is generally the first sign that therea problem. The fear is that if the shoulder does not quickly suppressed not to breathe the child in the situation, because the vaginal canal is compressed against the chest of the child. Additional maneuvers are then required to provide properly for the child.

If this is the case, most doctors initially freely over a variety of conservative methods for the child's shoulders. These procedures are part of the standard of care in delivery, where shoulder dystocia occurs, may include:

The ·McRobert maneuver, are hyperflexed where the mother's thighs, the pelvic outlet Expand

· Gaskin maneuver, in which the mother into a position on all fours, her hands and knees. This may not be in those cases as involving the epidural.

· Rubin I, where suprapubic pressure is applied to the mother's pubic bone, Turn themselves and distribute the shoulder under the pubic symphysis.

· Rubin II, in the back pressure on the frontShoulder

· Woods maneuver, in which the doctor inserts a hand turning on the fetus, or to facilitate the delivery of

· Jacquemier (or Barnum) maneuver is delivered when the rear shoulder and the chest, then his shoulder and the rest of the baby and

· Zavanelli maneuvers in the most dangerous and as a last resort. It is pushing the child's head back into the scabbard, and carry out a caesarean section.

TheIncidence of shoulder dystocia may cause serious injury and may include:

· Clavicular fractures (sometimes on purpose in the cervix clear)

· Fractures of the humerus (sometimes deliberately clear of the cervix)

· Temporary or permanent damage to the brachial plexus nerves (brachial plexus injury or Erb's palsy), the spine, you get the upper, middle and lower trunk, and run through the shoulder and down into the arms ofand hands.

· Hypoxia leading to brain damage or

· Death

Deliveries with shoulder dystocia occur in both diabetic and non-diabetic mothers. The incidence is higher in diabetic mothers who deliver more children. If you are a high risk for shoulder dystocia with birth, your doctor should perform an ultrasound examination to determine whether the child is the size of a problem. Your doctor should also discuss whether there will be a big episiotomynecessary or if a planned caesarean is the best way to ensure the health of the child. Caesarean section are not always the most practical solution for all cases, but if the birth weight of children high (macrosomia), there is maternal obesity, the mother has gestational diabetes and / or is there a history of shoulder dystocia, a caesarean will be displayed.