Seminars in Perinatology
Volume 31, Issue 3 , Pages 185-195, June 2007

After Shoulder Dystocia: Managing the Subsequent Pregnancy and Delivery

  • Edith D. Gurewitsch, MD

      Affiliations

    • Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD.
    • Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD.
    • Corresponding Author InformationAddress reprint requests to Edith D. Gurewitsch, MD, The Johns Hopkins Hospital, 600 North Wolfe Street, Phipps 217, Baltimore, MD 21287.
    • ,
  • Tara L. Johnson, BS, BM

      Affiliations

    • Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD.
    • ,
  • Robert H. Allen, PhD

      Affiliations

    • Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD.

Among risk factors for shoulder dystocia, a prior history of delivery complicated by shoulder dystocia is the single greatest risk factor for shoulder dystocia occurrence, with odds ratios 7 to 10 times that of the general population. Recurrence rates have been reported to be as high as 16%. Whereas prevention of shoulder dystocia in the general population is neither feasible nor cost-effective, intervention efforts directed at the particular subgroup of women with a prior history of shoulder dystocia can concentrate on potentially modifiable risk factors and individualized management strategies that can minimize recurrence and the associated significant morbidities and mortality.

Keywords: prior shoulder dystocia, history of shoulder dystocia, recurrence, brachial plexus palsy, injury prevention, risk management

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 Some of the research reported in this review was funded by a grant from the Centers for Disease Control’s National Center for Injury Prevention and Control: Grants for Traumatic Injury Biomechanics Research Program 04047: #CE00433-03. The contents of the article are the sole opinions of the authors and do not represent the opinions of the NCIPC.

PII: S0146-0005(07)00049-3

doi:10.1053/j.semperi.2007.03.009

Seminars in Perinatology
Volume 31, Issue 3 , Pages 185-195, June 2007

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