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Shoulder dystocia prevention involves a combination of appropriate labor management and skilled and properly executed delivery procedures. Shoulder dystocia is a birth complication occurring when there is difficulty in successfully delivering a baby’s shoulders. Shoulder dystocia prevention is possible, though it is not always possible to predict the occurrence of shoulder dystocia. Shoulder dystocia can result in injury or death to both the mother and the fetus.
There are several identifiable risk factors that can be evaluated during pregnancy in shoulder dystocia prevention efforts. The number one fetal risk factor is fetal macrosomia, or high birth weight. Babies weighing more than nine pounds have a three times greater risk of shoulder dystocia than smaller babies. Maternal risk factors include diabetes, previous shoulder dystocia complications, short stature, and abnormal pelvic anatomy. These factors can be predicted during pregnancy and appropriate shoulder dystocia prevention measures can be taken.
Shoulder dystocia prevention also involves proper medical birthing procedures. The use of excessive force during delivery, especially during forceps or vacuum techniques, is the leading cause of shoulder dystocia. Shoulder dystocia prevention involves medical professionals establishing protocol for how to respond to shoulder dystocia. This should take place before the actual delivery, especially in cases where shoulder dystocia risk factors are known. Some medical sources state that induction of labor and cesarean sections are not always appropriate shoulder dystocia prevention measures, as they do not always reduce the likelihood of shoulder dystocia.
Protocol for shoulder dystocia prevention has been developed by medical professionals and may be adapted where necessary in individual shoulder dystocia cases. The HELPERR mnemonic is an established protocol for shoulder dystocia prevention. This involves seven steps that can be taken to reduce risk of injury during shoulder dystocia complications. These include: recruiting sufficient medical help during delivery, episiotomy considerations, maternal leg repositioning, application of suprapubic pressure, rotation of the baby’s shoulders, fetal arm removal from the birth canal, and rolling the mother onto all fours in order to dislodge compaction and allow gravity to aid in delivery.
If proper shoulder dystocia prevention measures are not taken, medical negligence can cause serious injury to both the mother and the baby. Maternal injury can include hemorrhaging, tearing or bruising of the reproductive tissues, and uterine rupture. Fetal injury can cause brachial plexus palsy (nerve damage affecting the upper extremities), clavicle or humorous fracture, hypoxia or lack of oxygen to the brain (which may cause neurological damage) and even death.
The failure of shoulder dystocia prevention methods can be the result of medical negligence. If this is the case victims of shoulder dystocia injuries may be eligible to seek compensation of their damages through a civil legal case.