Shoulder dystocia is a childbirth emergency that occurs when one or both of the baby's shoulders get stuck inside the mother's pelvis during vaginal delivery, typically behind the pubic bone, making it difficult for the baby to be born after the head has already delivered. This condition often requires urgent medical maneuvers to safely deliver the baby and prevent serious complications for both mother and child, such as nerve injuries in the baby or increased risk of vaginal tears and bleeding for the mother.
Details of Shoulder Dystocia
- It happens after the baby's head is born but the shoulders fail to deliver properly despite gentle downward traction.
- A key sign is the "turtle sign," where the baby's head retracts back into the birth canal as if pulling into a shell.
- It is unpredictable and cannot usually be prevented, though larger babies, diabetes, previous shoulder dystocia, maternal obesity, and induced labor increase the risk.
- It occurs in about 0.6% to 3% of vaginal births, varying with factors like birth weight.
Risks and Management
- Shoulder dystocia is an obstetric emergency requiring quick and skilled intervention.
- The goal is to release the baby's shoulder(s) to avoid neonatal asphyxia or brain injury.
- Complications may include brachial plexus (nerve) injuries in the baby or maternal injuries.
- Various obstetric maneuvers may be used, such as repositioning the mother or manually rotating the baby, to safely deliver the baby.
In summary, shoulder dystocia is a rare but serious complication during vaginal birth, requiring immediate medical attention to ensure the safety of both mother and baby.
