Shoulder Dystocia
What to know about Shoulder Dystocia
We understand that experiencing complications during labour and delivery can be deeply concerning; if you are facing questions about shoulder dystocia, know that we can support you. We understand the anxieties surrounding birth injuries and are here to provide clear, trustworthy guidance.
Emergency Nature of Shoulder Dystocia
Shoulder dystocia is an obstetric emergency that requires immediate attention.
This occurs during delivery, specifically after the delivery of the head, when the baby’s anterior shoulder becomes lodged behind the mother’s pubic bone.
The emergency nature of shoulder dystocia stems from the baby’s head being delivered, but where the baby’s shoulder is stuck, and the baby’s neck has not emerged, causing potential oxygen deprivation.
Signs Indicating Shoulder Dystocia
One sign indicative of shoulder dystocia is the "turtle sign," where the baby's head retracts into the mother's pelvis.
While there are no symptoms to predict if shoulder dystocia can happen, an obstetrician may observe this sign after the delivery of the head. Recognition of this sign is crucial for prompt management of shoulder dystocia.
What are the Risks of Shoulder Dystocia?
Several risk factors for shoulder dystocia have been identified, and awareness of these factors is essential for preparation and management.
These risk factors can help healthcare providers anticipate and address potential complications during labour and delivery.
Foetal macrosomia, defined as a high estimated foetal weight, is a significant risk factor for shoulder dystocia.
If the baby’s birth weight is more than 8 pounds and 13 ounces, this increases the risk of shoulder dystocia. In cases of foetal macrosomia, healthcare providers may consider a C-section to mitigate potential complications during shoulder delivery.
Maternal diabetes, including gestational diabetes, is another critical risk factor for shoulder dystocia. Women with pre-existing diabetes or gestational diabetes have an increased risk of shoulder dystocia.
These conditions can lead to larger babies, further elevating the risk of shoulder dystocia during vaginal delivery.
A history of previous shoulder dystocia significantly elevates the risk for recurrent shoulder dystocia in subsequent pregnancies.
Awareness of this history enables medical teams to prepare for and manage shoulder dystocia effectively should it recur.
Shoulder Dystocia Manoeuvres
The McRoberts manoeuvre is a crucial, first-line intervention in the management of shoulder dystocia.
The McRoberts manoeuvre involves sharply hyper flexing the mother’s legs up to her abdomen. This manoeuvre widens the pelvis, flattening the lumbar spine.
Your obstetrician will ask you to press your thighs up against your belly. This method can facilitate the rotation and delivery of the foetal shoulder in shoulder dystocia cases, aiding in a safer vaginal delivery.
Suprapubic pressure is another essential, first-line manoeuvre employed to manage shoulder dystocia. The goal with suprapubic pressure is to manually push the anterior foetal shoulder downward from above the mother’s pubic bone. With suprapubic pressure, your obstetrician will press on your lower abdomen above your pubic bone.
Applying pressure at this location helps to rotate the baby’s shoulder, potentially dislodging it and allowing for shoulder delivery.
The Wood’s screw manoeuvre is a second-line obstetric manoeuvre employed when initial measures, such as the McRoberts manoeuvre and suprapubic pressure, prove insufficient to resolve shoulder dystocia.
To perform Wood’s screw manoeuvre, the obstetrician puts their hand inside the birth canal, next to the baby’s shoulder. This involves the obstetrician manually rotating the baby to dislodge the shoulder.
The Wood’s screw manoeuvre may encourage the delivery of the posterior shoulder and help resolve shoulder dystocia cases.
Potential Injuries from Shoulder Dystocia
The most severe complication arising directly from shoulder dystocia is hypoxic brain injury, which may tragically result in death if the baby’s shoulder is not delivered quickly.
Hypoxic injuries occur due to prolonged compression of the umbilical cord so if shoulder dystocia occurs, medical professionals must ack quickly to deliver the baby as soon as possible to prevent long-term damage.
Brachial plexus injuries are among the most common complications associated with shoulder dystocia, occurring when the brachial plexus nerves are stretched or torn during the shoulder delivery.
Brachial plexus injuries can result in a range of conditions, including brachial plexus palsy, which can affect movement and sensation in the arm and hand
Prompt and skilled obstetric manoeuvres are crucial in reducing the risk of shoulder dystocia and brachial plexus injuries.
During challenging shoulder dystocia cases, attempts to deliver the baby’s shoulder can lead to fractures.
Fractures of the clavicle (collarbone) or humerus (upper arm bone) may occur as additional obstetric manoeuvres are undertaken to resolve the impaction. These fractures, while concerning, often heal well.
Should you need assistance with birth injury claims, our team of expert lawyers are on hand to help.
Doctors have a crucial role in recognising risk factors for shoulder dystocia. Doctors must know the risk factors to watch for in high-risk deliveries and be ready to handle this complication in any delivery, to prevent injury during labour and delivery.
Many birth injuries related to shoulder dystocia are preventable, particularly when appropriate and timely procedures are followed. Birth injuries caused by shoulder dystocia are among the most preventable, especially if the procedures are undertaken in a proper and timely manner.
If risk factors for shoulder dystocia have been identified, taking the correct steps becomes even more critical.
Legal Implications
Negligence claims may arise if injuries occur because of the mishandling of shoulder dystocia.
Negligent doctors often claim that, due to shoulder dystocia causing a medical emergency, any injuries caused by excessive pulling and twisting of the baby are unavoidable.
Understanding the legal implications is crucial; families affected by such incidents may need to consult with a skilled lawyer to assess their options and pursue rightful compensation for birth injuries.
How We Can Help
Expert Legal Advice
If your baby has sustained a birth injury related to shoulder dystocia, seeking expert legal advice is essential.
Our team of experienced lawyers specialises in birth injury claims and can provide the guidance you need as we understand the complexities of shoulder dystocia cases and are committed to helping you navigate the legal process.
Our Accreditations
