Shoulder Distortion During Delivery

What It Is

Shoulder dystocia is an issue of labor and delivery in which one or both of the baby’s shoulders get “stuck” behind the mom’s pelvic bone as the baby descends into the birth canal.

How Common Is It?

Only one percent of infants weighing 6 pounds have shoulder dystocia; five to nine percent of children weighing more than 9 pounds have shoulder dystocia.

Although the definition is inaccurate, it occurs in around 0.3-1% of vaginal births.

Who Is Most at Risk?

Shoulder dystocia happens most often in larger infants. Women who’ve previously delivered a baby with shoulder dystocia or those who have gestational diabetes are also at risk. The risk likewise increases if you go past your due date before providing or have to be helped by forceps or vacuum during childbirth. Still, lots of cases of shoulder dystocia occur during labors with no of these risk factors.

What Are the Symptoms Shoulder Distortion?

One attribute of a minority of shoulder dystocia deliveries is the turtle sign, which includes the appearance and retraction of the fetal head (analogous to a turtle withdrawing into its shell), and the erythematous (red), puffy face a sign of facial flushing. This occurs when the baby’s shoulder is blocked by the maternal pelvis.

Should You Be Concerned About Shoulder Distortion During Delivery?

Both you and your baby are at risk for complications of shoulder dystocia, nearly all of which come as a result of the maneuvers that may have to be required to remove your baby from the birth canal. Luckily, those complications (such as nerve injury or breaks and fractures in the collarbone or arms of the baby or hemorrhage, significant tearing of your perineum, uterine rupture, and other pelvic injuries for the mother) are unusual.

Complications

The major concern of shoulder dystocia is damage to the upper brachial plexus nerves. These supply the sensory and motor elements of the shoulder, arm and hands. The aetiology of injury to the fetus is debated, however a probable system is manual stretching of the nerves, which in itself can cause injury. In addition, excess stress may physically tear the nerve roots out from the neonatal spine, resulting in overall dysfunction. The forward roots (motor pathway) are most susceptible to injury, as they are in the aircraft of greatest tension (anterior, sensory nerves are rather secured due to the typical inward motion of the shoulder).

  • Klumpke paralysis
  • Erb’s Palsy
  • Fetal hypoxia
  • Fetal death
  • Spastic paralysis
  • Maternal post partum hemorrhage (11%).
  • Vaginal lacerations and 3rd/4th degree tears, extended episiotomies.
  • uterine rupture.

Shoulder Distortion Prevention

Keep your weight gain within the recommended variety so your baby doesn’t get too huge to maneuver through the birth canal. Choosing a labor position that allows your pelvis to open as large as possible may offer you the best opportunity of preventing dystocia. If you do have shoulder dystocia during labor, your practitioner might attempt to change your position, ask you to hyperflex your knees as much as the abdominal area, or use pressure to the top of your pelvis to assist the baby be delivered.


Last Update - September 23, 2017

References

The Author

Reyus Mammadli

As a healthy lifestyle advisor I try to guide individuals in becoming more aware of living well and healthy through a series of proactive and preventive measures, disease prevention steps, recovery after illness or medical procedures. Education: Bachelor Degree of Medical Equipment and Electronics.

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