gynecology and obstetrics
Shoulder Dystocia
Introduction
Shoulder dystocia occurs during an attempted vaginal delivery (in the second stage of labor [pushing]) when the fetal head delivers but delivery does not progress because the anterior shoulder is impacted behind the pubic symphysis or the posterior shoulder is obstructed by the sacral promontory. It is an obstetric emergency and may result in fetal injury or death or maternal injury. Shoulder dystocia is an obstetric emergency that occurs in approximately 0.2% to 3.0% of vaginal deliveries (with a vertex fetal presentation) ( General reference ). Risk factors for shoulder dystocia should be noted during prenatal care and, if a patient is at increased risk, preparations should be made for a potential shoulder dystocia. If the risk is very high, a planned cesarean delivery may be appropriate. 