Shoulder Dystocia During Birth

 

Shoulder Dystocia

Video taken from the channel: Surgery 101


 

Dr. Jones Explains Shoulder Dystocia on One Born Every Minute

Video taken from the channel: OhioHealth


 

Shoulder Dystocia Midwife Secrets You Need to KnowDad and Midwife Q&A

Video taken from the channel: Cajun Stork Midwife Kira at Natural Birthhouse


 

Shoulder Dystocia During Delivery

Video taken from the channel: Trial Exhibits, Inc.


 

Shoulder Dystocia Medical Animation

Video taken from the channel: Trial Exhibits, Inc.


 

How to Deliver During Shoulder Dystocia | Merck Manual Professional Version

Video taken from the channel: Merck Manuals


 

Having a forceps delivery Understanding Shoulder Dystocia | One Born Every Minute

Video taken from the channel: One Born Every Minute


Shoulder dystocia occurs when a baby’s head passes through the birth canal and their shoulders become stuck during labor. This prevents the doctor from fully delivering the. Shoulder dystocia is a birth trauma that happens when the mother has difficulty pushing the baby out during delivery due to one or both of a baby’s shoulders. Shoulder dystocia is a condition that occurs during childbirth when the shoulders of an infant are stuck in the pelvic of the mother, mostly because the baby is too large for the birth tube.

Other causes can be when the baby is born face first, pulled. Shoulder dystocia happens in about 1 in every 200 births. It’s more common during a vaginal birth, but a baby’s shoulder can also get stuck during a caesarean. Shoulder dystocia is a medical emergency. Your provider may: Press your thighs up against your belly.

This is called the McRoberts maneuver. Press on your lower belly just above your pubic bone. This is called suprapubic pressure.

Help your baby’s arm out of the birth canal Reach up into the vagina to try to turn your baby. Or turn you over. The single most common risk factor for shoulder dystocia is the use of a vacuum extractor or forceps during delivery. 2 However, most cases occur in.

Shoulder dystocia is a complication during vaginal childbirth that occurs when the baby’s shoulder becomes stuck behind the mother’s pelvic bone. Shoulder dystocia can be one of the most catastrophic events in modern-day delivery rooms causing great anxiety even for experienced doctors. Dr. Roshan says time is of the essence when a baby has shoulder dystocia during a delivery. “Usually you have five minutes to get the baby out after the head is. Shoulder dystocia is an obstetric emergency in which normal traction on the fetal head does not lead to delivery of the shoulders.

This can cause neonatal brachial plexus injuries, hypoxia, and. Shoulder dystocia is an obstetrical emergency during childbirth that occurs when a baby’s anterior shoulder becomes stuck behind the mother’s pelvic bone preventing the baby from continuing through the birth canal. Shoulder dystocia is a comparatively common type of obstetrical complication.

List of related literature:

There is a history of shoulder dystocia at birth.

“Certification and Core Review for Neonatal Intensive Care Nursing E-Book” by AACN, AWHONN, NANN, Robin L. Watson
from Certification and Core Review for Neonatal Intensive Care Nursing E-Book
by AACN, AWHONN, et. al.
Elsevier Health Sciences, 2012

Both obstetric and pediatric providers should debrief the shoulder dystocia event immediately after the delivery.

“Avery's Diseases of the Newborn E-Book” by Christine A. Gleason, Sherin Devaskar
from Avery’s Diseases of the Newborn E-Book
by Christine A. Gleason, Sherin Devaskar
Elsevier Health Sciences, 2011

Shoulder dystocia is an uncommon obstetric emergency that increases the risk for fetal and maternal morbidity and mortality during the attempt to accomplish birth vaginally.

“Maternity and Women's Health Care E-Book” by Deitra Leonard Lowdermilk, Shannon E. Perry, Mary Catherine Cashion, Kathryn Rhodes Alden
from Maternity and Women’s Health Care E-Book
by Deitra Leonard Lowdermilk, Shannon E. Perry, et. al.
Elsevier Health Sciences, 2014

Shoulder dystocia is a rare but potentially serious complication that occurs when the baby’s head has been born, but the birth of her shoulders is delayed because they’re too broad to fit through the pelvis.

“Pregnancy, Childbirth, and the Newborn: The Complete Guide” by Janet Walley, Penny Simkin, Ann Keppler, Janelle Durham, April Bolding
from Pregnancy, Childbirth, and the Newborn: The Complete Guide
by Janet Walley, Penny Simkin, et. al.
Meadowbrook, 2016

Shoulder dystocia cannot be strictly prevented because normal term fetuses, with shoulders wider than the fetal head, are at some risk for shoulder dystocia, and most infants of mothers without diabetes with shoulder dystocia are not macrosomic!7-21.

“Clinical Maternal-Fetal Medicine” by Hung N. Winn, John C. Hobbins
from Clinical Maternal-Fetal Medicine
by Hung N. Winn, John C. Hobbins
Taylor & Francis, 2000

Shoulder dystocia occurs when after the delivery of the head, the shoulders cannot be delivered secondary to impaction on the maternal pelvis.

“Miller's Anesthesia, 2-Volume Set E-Book” by Michael A. Gropper, Ronald D. Miller, Lars I. Eriksson, Lee A Fleisher, Jeanine P. Wiener-Kronish, Neal H Cohen, Kate Leslie
from Miller’s Anesthesia, 2-Volume Set E-Book
by Michael A. Gropper, Ronald D. Miller, et. al.
Elsevier Health Sciences, 2019

If concerned about the risk of shoulder dystocia, others will ask an assistant to apply suprapubic pressure to the fetal shoulder during the birth of the shoulder (there is no evidence that this technique is effective in preventing shoulder dystocia).

“Midwifery: Preparation for Practice” by Sally Pairman, Sally K. Tracy, Carol Thorogood, Jan Pincombe
from Midwifery: Preparation for Practice
by Sally Pairman, Sally K. Tracy, et. al.
Elsevier Health Sciences, 2011

Shoulder dystocia can be recognized from the “turtle sign”: The fetal head will begin to protrude and then withdraw back inside because the shoulders are too large to exit the uterus.

“Critical Care Transport” by American Academy of Orthopaedic Surgeons (AAOS), American College of Emergency Physicians (ACEP), UMBC
from Critical Care Transport
by American Academy of Orthopaedic Surgeons (AAOS), American College of Emergency Physicians (ACEP), UMBC
Jones & Bartlett Learning, 2017

The most important risk factors for shoulder dystocia are fetal macrosomia and maternal diabetes.

“Hacker & Moore's Essentials of Obstetrics and Gynecology E-Book” by Neville F. Hacker, Joseph C. Gambone, Calvin J. Hobel
from Hacker & Moore’s Essentials of Obstetrics and Gynecology E-Book
by Neville F. Hacker, Joseph C. Gambone, Calvin J. Hobel
Elsevier Health Sciences, 2009

Shoulder dystocia is more common when the baby is very big at birth (around ten pounds or more), but it can happen to smaller babies as well.

“Our Bodies, Ourselves: Pregnancy and Birth” by Boston Women's Health Book Collective, Judy Norsigian
from Our Bodies, Ourselves: Pregnancy and Birth
by Boston Women’s Health Book Collective, Judy Norsigian
Atria Books, 2008

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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28 comments

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  • Lying on your back not the optimal position for birth. What if the mama stood upright. Would this not support a baby with shoulder dystocia?

  • Unfortunately this baby will suffer from long term subtle cognitive (and other ) sequaelae. Most of this will go unnoticed (ADHD, various learning disabilities, lower IQ), besides nobody is really willing to discuss this with the parents. Out of fear of possible ligitation.

  • There was some research which showed that babies are so big nowadays because mothers are taking baby vitamins during their 2nd and 3rd pregnancy. It’s not unusual in past few years to have baby which weights over 4 kg, even if it’s a baby girl. When I learnt this, I restrained myself from taking those. I wanted to give a birth to a baby, not to a child:)

  • I gave birth to my first on Wednesday February 28

    I had a natural birth

    I was screaming and panicking it was really really painful

    I felt lots of burning and pressure while I was pushing

    When I felt like I needed to bear down and push I told the nurse but she wouldn’t let me push yet even though I felt like I really had to push because my delivery doctor was at another delivery

    The scariest part of my delivery was when my babies shoulder got stuck shoulder dystocia The nurse at my delivery had to put pressure on my belly super pubic pressure there was a nurse on either side of me pushing my legs way way back to make it easier for baby to be born I had to push very hard harder than I already was pushing

    The most intense parts
    was when my delivery doctor was stretching me so I didn’t tear

    The other intense part was when my delivery doctor told me not to push during one of the final contractions so she could suction my baby

  • You are shitting me! So instead of giving her a c-section, they mangled her genitals with forceps and then broke her baby’s collar bone to get him out? vaginal births are NOT ALWAYS best.

  • I was a shoulder dystocia baby and this is terrifying! My mom is EXACTLY average height for a white American woman at 5’4″ and I was EARLY! So a preemie being carried by a woman of average size and yet still had this happen to us! My mom had always told me my delivery was assisted, so growing up I’d hear about “the vacuum” and it was kind of a joke when I was a kid. Then when I got older and started having neurological troubles, I decided to do some research on potential impacts of assisted births and/or shoulder dystocia on people once they were older, and found out more about it. My mom has always been my hero but this makes me even more proud to be hers!

  • brachial plexus injury most comon complication,mcroberst maneuver may lead to meralgia paresthetica,very nice video,i appreciate your effort

  • I had a failed forceps delivery that resulted in an emergency c section. I’m still so upset that nothing about my pregnancy went well. At some point during the delivery my son suffered a life long brain injury from lack of oxygen. ��

  • Just a quick ask if I may? My sister recently gave birth to a baby boy and it was the forcep delivery! Just wanted to ask if it is good or bad for the baby what precautions we can take etc etc.

  • I had 2 shoulder dystocia babies, my first baby nearly died and had to be resuscitated, my second wasn’t as bad but still was very stuck! With my third child I had discussed a c section with my midwife and was told i couldnt have one, after being in labour for 27 hours and still only at 5cm I was taken for an emergency c section once opened up my baby had his cord wrapped around his neck and the surgeons all agreed that me or my baby should not of been put in that situation.

  • My son was a should dystocia baby in 2006. My obgyn knew he was large from the beginning and we discussed a c section due to his size and my size. During the holiday weekend (new years) my regular doc was out and his partner was in. Missed communication happened and I delivered vaginally. He of course got stuck, the doc had to break his left upper arm to bring him out. Spent some time in the NICU and has healed fine, thank goodness.

  • This is beautiful despite a lil difficulty. I’m 32 weeks and I’m having a scheduled csection because I have gestation diabetes and my baby is measuring big. I’m so sad but I wouldn’t want anything to happen to my lil one. Has anyone else been n the same situation?

  • Hi! I have a question! I’m going to be doing an unassisted birth if they quarantine where I am. what do I do if this happens? (Dystocia) how do I get her out if she gets stuck? How will I know? Thank you!

  • My eldest grandson was born with shoulder dystocia. He was born at 36 weeks weighing 10lb 5oz and 24″ long. His arm would flopped down when you picked him up. It was heartbreaking to see my daughter doing his physiotherapy whilst he was screaming his head off, but it was necessary and now 28 years later he is fine.

  • This happened with my daughter.

    9lbs 2oz I’m just over 5ft very petite in frame.

    I knew there was something wrong when the said you been pushing to long with no progress so up to theater we went. Then they couldn’t find any of her vitals so it was panic stations they realised she was stuck and being starved of oxygen. Worst but when they got her out and they call for more people alarms buzzing and I have to watch my child go thru neonatal resuscitation after that we found she had sepsis and was in the NICU for a while but now I’m so lucky she’s 22 months old it’s 12:38 am I got her on the baby monitor running from one side the cot to the other laughing. The surgens midwifes and doctors saved my baby. For that I’m eternally grateful. I’m 8 weeks pregnant with our second and it’s coming back to haunt me now. I know that team is at that hospital though so I can relax a bit knowing that they will try there best.

    I’m so lucky and greatful. My Esther is perfect

  • came here out of curiosity. I was a forcep baby and I’m 23 now. Wow. This is Terrifying. My respect for my mother just leveled up 1000x more.

  • Standing upright can increase the diameter of the pelvic outlet, but generally doctors don’t like delivering standing upright because of the potential for dropping the newborn. In the cases of shoulder dystocia, Gaskins Maneuver can be used, in which a mother gets on “all fours” and arches her back in order to increase the pelvic outlet.

  • This happen 18 months ago with my daughters first baby. He was 10lb 6onz and she is a small framed girl. Then my other daughter just had her first today. Her little girl was 8lb 14 onz and my daughter who is 22 is the size of a 12 yr old if not smaller. had the same thing happen. I was at both births. I can not believe this happened to both of my girls. I have 4 girls… and another one of them is due to have her first in 10 weeks and I am so worried it will happen to her too. All my girls have small frames. Praying all goes well….

  • If only they allowed women (and women demanded) to be upright, undrugged and an active part of their own births. Forceps are overused, and if you understand how birth works, it is obvious that using forceps as opposed to a woman birthing in her own power would lead to the shoulders being in the wrong position. Not that shoulder dystocia doesn’t happen even after lovely instinctual births, but this is an obvious example of someone causing a serious problem that likely would have been avoided.

  • I can’t even begin to imagine how terrified the mummy must have been, you can see staff are very panicked! The father was in pure shock, thank god the theatre staff acted very quickly

  • This happened with me, but they had to take me into theatre in case they had to do an emergency c-section. After 20 hours of labour I was wheeled into theatre on my hospital bed. my husband had to get changed into hospital clothes to be able to join me so I was alone in there for what felt like about half an hour while they were preparing everything. There must have been about 10 doctors, midwifes and nurses in the room with me, all asking me questions upon questions upon questions. I was terrified. When my husband finally joined me, they had to cut me to be able to get the forceps in. Once they did, my daughters head was born in the next contraction, they then had to make the cut bigger because she couldn’t fit through (thankfully I was so out of it at that time, I didn’t realise it was happening) in the next contraction my daughter was born, weighing in at 10lbs 2 oz. I had lost so much blood that I almost needed a blood transfusion. Afterwards my husband told me he thought they were going to ask him if they should save me or the baby, he was sure we weren’t both going to make it. Thankfully our baby was completely healthy apart from some small cuts on her head/face, but those quickly healed. I can’t say the same for myself though. I wasn’t able to walk for days and now, 5 months later I am still suffering from hip pain and I can’t walk long distances, not to mention the damage done down below. thankfully though no serious injury, it could have been so much worse. But because of this traumatic experience I had real trouble bonding with my baby which made the first few months of being a new mum hell for me. I am just now starting to really love my baby. If I ever have another baby I will opt for an elected c-section. Nobody should have to go through this.

  • So i had one baby with shoulder dystocia. She was my 1st and i had gd. My 2nd, 3rd were fine!! and this one (im due in march) they dont want me to have a water birth because of this. Can you explain?

  • Dr. Jones I really like how you explained all the steps that can be done to delivery large baby vaginally. My son was measuring 10 lbs 2oz at 38.5 weeks and my OB said due to risks involved we will go ahead with csection in the next few days. My son was 11 lbs 2.4 oz at 39 weeks. I am kind of glad I didn’t go through natural birth because, of the risks involved and all that mom has to go through to deliver large baby. I mean I get it its mother nature but, we have to do whats best for our babies. Part of me wished that he had tried to deliver my son naturally but, part of me also says its good that c-section was performed.

  • I am a big fan of you.you are such a motivating girl. I have a small question. I had UTI infection then doctor gave me lot of tablets antibiotics. I am using them but I got confirmed was I am pregnant is that ok or antibiotics will effect my baby future growth. And I also had alcohol one day before I knew was pregnant �� is that ok to continue this baby please let me know

  • such a dangerous procedure should be forbidden to execute in the 21st century!!! can cause serious damage for both…
    why are doctors still waiting for a sectio so long?

  • I had a csection due to failed attempts to dislodge. Luckily, my baby girl was healthy and suffered no complications thanks to my experienced doc:) she was only 7lbs and I didnt have diabetes. I was induced though.

  • This did such a painful birth as giving birth isn’t painful enough I had one of these birth with my last child he has his dad shoulders it took 5 hours to get him out he was 14 pounds and 14 oz and 24 inches long he was a big baby. He was my first child now I’m caring my 9 th child. I give birth on valentines days.

  • Are there any guidelines for providers on when to decide to deliver a baby via cesarean section to prevent shoulder dystocia? This video brings up a good point about shoulder dystocia being unpredictable and how it varies from case to case.