Shoulder dystocia

Question 1

What are the complications of shoulder dystocia

Answer 1

→ High rate of fetal mortality and morbidity

→ Brachial plexus injuries

Question 2

What are RF for shoulder dystocia

Answer 2

most occur in women w no RFs!!
large/post-mature fetus
BMI >30 
IOL (w oxytocin)
Prolonged 1st/2nd stage
prev. SD
DM
Instrumental delivery

Question 3

How can SD be avoided?

Answer 3

CS if diabetic or fetus >4500g

Question 4

Describe the management of SD

Answer 4

HELPERR

1. get Help
2. Episiotomy
3. Legs - McRoberts
4. Suprapubic Pressure
5. Enter: rotational manouevres
6. Remove posterior arm
7. Roll patient onto hands and knees

Question 5

How should death of the fetus be managed?

Answer 5

cut clavicles to assist delivery

Question 6

What is the potential damage to the fetus because of SD

Answer 6

Erb’s palsy

fractured clavicle