Shoulder Dystocia

Shoulder dystocia is an emergency situation during a delivery that occurs when the baby's head has been successfully delivered, but the shoulders appear to be stuck. When shoulder dystocia has been diagnosed action is then needed to safely deliver the rest of the body without injury.

There are several dangers with shoulder dystocia:

• There may be too much force applied to the head and neck and the baby gets injured

• If the baby is not delivered within a certain time frame (especially over 8-12 minutes), he may be starved of oxygen.

The delivery team will need to use certain steps to safely deliver the baby. The steps may include:

1. Communication with the patient and others
2. Timing and documentation
3. Stopping to push
4. Relaxing the uterus
5. Stopping Oxytocin
6. Episiotomy
7. No traction on the head
8. McRoberts maneuver
9. Suprapubic pressure
10. Woods/Rubin maneuvers
11. Zavanelli maneuver
12. "All Fours" (Gaskin) maneuver
13. Breaking clavicle
14. Delivery of the posterior arm

Shoulder dystocia is more likely to occur where the mother is obese, there is an instrumental (vacuum or forceps) delivery, labor has been abormal, the baby is particularly large, where the mother has a small pelvis, or in women with diabetes. If this condition has occurred in a previous pregnancy, then there is an increased risk in the next pregnancy.