Shoulder dystocia is a condition when one or both of the baby's shoulders get stuck in the birth canal during labour. This condition can cause labor to be obstructed, endangering the mother and baby.
 |
| Shoulder Dystocia, Causes, Diagnosis, Treatment, Prevention, Complications |
Shoulder dystocia is very rare and is a medical emergency. This condition is also difficult to predict, because it can occur even if the baby has normal weight and the mother has no risk factors.
Causes of Shoulder Dystocia
The main causes of shoulder dystocia are the size of the baby's shoulders that are larger than the size of the mother's pelvis (cephalopelvic disproportion), the diameter of the mother's pelvis is small, or the fetus is in the wrong position (malpresentation) when entering the birth canal.
Risk factors for shoulder dystocia
Although it can occur at any birth, there are several factors that can increase the risk of developing shoulder dystocia, namely:
- Age of pregnant women over 35 years
- Large fetal size (macrosomia)
- The shape of the mother's pelvic bones is abnormal due to congenital abnormalities or a history of hip fractures
- The height of pregnant women is less than 145 cm
- Pregnant women suffer from obesity or diabetes
- History of shoulder dystocia in previous delivery
- Post-term pregnancy, namely pregnancy more than 42 weeks
- Induction of labour
- Twin pregnancy
Symptoms of Shoulder Dystocia
Shoulder dystocia does not cause any symptoms before delivery. However, at the time of delivery, shoulder dystocia can give rise to the following conditions:
- The baby's head is out, but the body cannot pass through the birth canal
- Baby's head is out but then coming back into the birth canal (turtle sign)
The two conditions above cause labor to be obstructed or jammed so that it takes a long time.
When to see a doctor
Labor emergencies, such as shoulder dystocia, are often difficult to predict. Therefore, carry out routine controls to the doctor during pregnancy, to assist the doctor in checking the estimated size of the baby and the birth canal. This will help the doctor in giving advice on the best delivery method.
Diagnosis of Shoulder Dystocia
As previously explained, shoulder dystocia is an emergency. During delivery, doctors can immediately diagnose shoulder dystocia if the baby has the following conditions:
- The baby's head is out, but the baby's body can't come out
- The baby's body does not come out after more than 1 minute
In addition, doctors can predict shoulder dystocia if there are conditions that put the mother and fetus at risk, such as the size of the fetus that is too large or the mother's pelvis is narrow. This condition can be detected through an ultrasound examination when carrying out routine controls.
Shoulder Dystocia Treatment
Doctors can perform several techniques to treat shoulder dystocia, including:
- McRobert Technique
In this technique, the doctor will direct the mother to raise her thighs towards the stomach so that the mother's stomach becomes depressed. This technique is generally the first method of dealing with shoulder dystocia.
- Suprapubic technique
This technique is much the same as McRobert's, but the doctor or nurse will apply pressure on the area above your pubic bone (suprapubic). This technique allows the baby's shoulder to move and not get stuck.
- Rubins technique
In this technique, the doctor will insert two fingers under the baby's shoulder to help move the shoulder. This technique is done so that the baby's shoulders become parallel.
- Wood's technique
Just like the Rubin technique, the doctor will insert two fingers under the baby's shoulders. In the Woods technique, the doctor will rotate the baby's position so that it is sideways. When the position is changed, the baby may be able to come out easily.
- gaskin technique
This technique is done by asking the mother to change position to crawl. The Gaskin technique will widen the diameter of the pelvis so that the baby's body will be easier to expel.
- Zavanelli technique
In this technique, the doctor will push the baby's head back into the uterus. After that, the doctor will perform a caesarean section to remove the baby. However, this technique is quite dangerous to do.
If these techniques are not enough to help the delivery process, the doctor will use forceps or a vacuum.
Complications of Shoulder Dystocia
Complications of shoulder dystocia can occur in the mother or the baby. Some of the complications that can occur in the mother are:
- Running out of energy to push so that labor is getting hampered
- Severe bleeding after delivery
- Formation of an abnormal passage between the rectum and vagina (rectovaginal fistula)
- The uterus is torn during delivery
- The joints in the hip bones are separated
- Tears in the vagina and anus
Meanwhile, some of the complications that can occur in infants are:
- Nerve damage that regulates the movement of the baby's arms and shoulders (brachial plexus) can cause the baby's arms to become paralyzed, namely Erb's palsy
- Broken collarbone or upper arm bone
- Horner's Syndrome
- The umbilical cord is caught between the baby's arm and the mother's pelvic bone
- Lack of oxygen (asphyxia)
- Brain damage
Prevention of Shoulder Dystocia
Shoulder dystocia is a condition that is quite difficult to prevent. However, there are several efforts that can be made by mothers to reduce the risk of shoulder dystocia, namely:
- Control blood sugar levels if you have diabetes
- Maintain body weight to remain ideal before pregnancy
- Maintain normal weight gain during pregnancy
- Undergo a doctor's examination immediately if you haven't given birth after the estimated date of delivery
- Carry out routine pregnancy control
Related Searches:
- shoulder dystocia,
- shoulder dystocia maneuvers,
- shoulder dystocia and a compressed umbilical cord,
- what is shoulder dystocia,
- shoulder dystocia death,
- shoulder dystocia complications,
- baby shoulder dystocia,
- suprapubic pressure shoulder dystocia,
- shoulder dystocia risk factors,
- shoulder dystocia definition,
- shoulder dystocia complications for baby,
- risk factors for shoulder dystocia,
- shoulder dystocia treatment,
- shoulder dystocia birth,
- treatment for shoulder dystocia,
- treatment of shoulder dystocia,
- how common is shoulder dystocia,
- shoulder dystocia icd 10,
- mcroberts maneuver shoulder dystocia,
- risk of shoulder dystocia,
- shoulder dystocia acog,
- management of shoulder dystocia,
- acog shoulder dystocia,
- shoulder dystocia management,
- risk of shoulder dystocia in second delivery,
- shoulder dystocia nursing interventions,
- helperr shoulder dystocia,
- shoulder dystocia baby,
- shoulder dystocia long term effects,
- shoulder dystocia interventions,
- risks of shoulder dystocia,
- shoulder dystocia maneuver,
- cause of shoulder dystocia,
- shoulder dystocia statistics,
- newborn shoulder dystocia,
- causes of shoulder dystocia,
- shoulder dystocia long-term effects,
- shoulder dystocia causes,
- signs of shoulder dystocia,
- shoulder dystocia newborn,
- shoulder dystocia delivery,
