Shoulder Dystocia

03/06/2015 - "The psychosocially deprived women were diagnosed with GDM earlier, received insulin treatment during pregnancy more often and were more likely to have LGA infants (15.1% vs 10.6%, OR=1.5 (95% CI 1.02 to 2.2), p<0.05) and shoulder dystocia (3.1% vs 1.2%, OR=2.7 (0.97 to 7.2), p<0.05). "
01/01/2015 - "(2)To the GDM patients with intensive prenatal intervention, reviewed form 5 articles, it was found that the incidence of shoulder dystocia was reduced significantly by intensive intervention(diet control combined with insulin if necessary)versus less intensive intervention (only diet control), OR = 0.29 (95%CI:0.11-0.73, P = 0.009). "
07/01/1996 - "The purpose of this study was to test the hypothesis that the incidence of shoulder dystocia could be reduced in insulin-requiring diabetic women by elective induction of labor at 38 to 39 weeks of gestation. "
02/01/2006 - "Although treated with insulin, macrosomia still occurred in patients with GDM, but there was no shoulder dystocia as there was an increase in the incidence of cesarean section (CS). "
07/01/1996 - "We conclude that elective induction of labor is suggested for insulin-requiring diabetic women in order to reduce the incidence of shoulder dystocia."

07/01/2022 - "The meta-analysis showed that maternal age, gestational age, occiput posterior presentation, oxytocin augmentation, operative delivery, and shoulder dystocia were associated with the risk of recurrent OASIs in the subsequent delivery. "
04/01/2005 - "Shoulder dystocia was associated with use of oxytocin and instrumental deliveries. "
01/01/1999 - "There were no differences between the groups in mode of delivery, infant weight, rate of hyperstimulation, shoulder dystocia, patient discomfort, epidural use, oxytocin use, or nonreassuring fetal heart rate patterns. "
11/01/1990 - "Among macrosomic babies, shoulder dystocia was not associated with maternal stature, induction of labour, use of oxytocin or abnormal labour patterns, but was associated with instrumental delivery. "
04/01/1986 - "Oxytocin augmentation was used twice as often, and the incidence of shoulder dystocia appeared significantly higher in the control group. "

06/01/2009 - "Fetal size and growth velocity in the prediction of shoulder dystocia in a glucose impaired population."
02/01/2007 - "A positive relationship was found between the severity of maternal fasting hyperglycaemia and the risk of shoulder dystocia, with a 1 mmol increase in fasting oral glucose-tolerance test leading to a relative risk (RR) of 2.09 (95% CI 1.03-4.25). "
09/13/2016 - "There were positive linear associations with caesarean section, induction of labour, large for gestational age, macrosomia, and shoulder dystocia for all glucose exposures across the distribution of glucose concentrations. "
06/01/2004 - "The last two periods (1993-1999) were characterized by lower mean glucose level, lower mean gestational age at delivery, and a decline in macrosomia, shoulder dystocia and perinatal mortality rates, but also by high rates of labor induction and Cesarean delivery. "
01/01/2023 - "Statistically significant secondary outcomes included differences in two-hour glucose tolerance postpartum (gestational diabetes; two studies: standardized mean difference 9.62 mg/dL [95% CI: 1.95; 17.28]) that favored the control (GRADE level, very low) and risk of shoulder dystocia (four studies: log odds -1.34 [95% CI: -2.61; -0.08]) that favored telemedicine (GRADE, low). "

01/01/2021 - "Accordingly, the treatment of mild GDM significantly reduced the risk of macrosomia (OR = 0.3; 95%CI = 0.3-0.4), large for gestational age (OR = 0.4; 95%CI = 0.3-0.5), shoulder dystocia (OR = 0.3; 95%CI = 0.2-0.6), caesarean-section (OR = 0.8; 95%CI = 0.7-0.9), preeclampsia (OR = 0.4; 95%CI = 0.3-0.6), elevated cord C-peptide (OR = 0.7; 95%CI = 0.6-0.9), and respiratory distress syndrome (OR = 0.7; 95%CI = 0.5-0.9) compared to untreated counterparts. "
04/01/2012 - "Adverse pregnancy outcomes included birth weight, newborn percent body fat, and cord C-peptide >90th percentiles, primary cesarean delivery, preeclampsia, and shoulder dystocia/birth injury. "
02/01/2011 - "Groups were compared by test of trend for a composite perinatal outcome (neonatal hypoglycemia, hyperbilirubinemia, elevated cord C-peptide level, and perinatal trauma or death), frequency of large for gestational age neonates, shoulder dystocia, and pregnancy-related hypertension. "
09/01/2010 - "The results of the hyperglycemia and adverse pregnancy outcome (HAPO) study demonstrate a linear association between increasing levels of fasting, 1- and 2-h plasma glucose post a 75 g oral glucose tolerance test to several significant outcome endpoints, such as birth weight above the 90th percentile, cord blood serum C-peptide level above the 90th percentile, primary cesarean delivery, clinical neonatal hypoglycemia, premature delivery, shoulder dystocia or birth injury, intensive neonatal care admission, hyperbilirubinemia, and preeclampsia. "

01/01/2017 - "Perinatal death, pre-eclampsia, fetal anomaly, birth trauma including shoulder dystocia, nerve palsy, or fracture, and the composite outcome measure of neonatal morbidity were not reported.5. One trial (N = 223 women) comparing insulin Aspart with human insulin reported none of the review's primary outcomes: macrosomia, perinatal death, pre-eclampsia, caesarean section, fetal anomaly, birth trauma including shoulder dystocia. "

12/01/2012 - "Stratified analysis revealed that the adjusted ORs for 3rd or 4th degree perineal tears in these critical conditions (Macrosomia OR=2.3; instrumental deliveries OR=1.8; NRFHR patterns OR=2.1; occipito-posterior position OR=2.3; and shoulder dystocia OR=2.3) were similar to the crude OR (OR=2.3). "
01/01/2003 - "Univariate analysis with calculation of odds ratios (ORs) was used to determine which of the chosen risk factors were significantly related to the incidence of shoulder dystocia. "
05/01/2010 - "For all the adverse outcomes, the ORs increased continuously from the reference group up to > or =5,000 g in which the highest adjusted ORs were observed for shoulder dystocia [64.2 (confidence interval 55.7-74.0)] and plexus injuries [47.7 (confidence interval 35.7-62.4)]. "
10/01/2018 - "Maternal (primary or repeat cesarean delivery, third- or fourth-degree lacerations, severe postpartum hemorrhage, hypertensive disease of pregnancy) and neonatal (preterm birth, shoulder dystocia, macrosomia, hypoglycemia) outcomes were compared among women in the gestational weight gain categories in unadjusted and adjusted analyses with odds ratios (ORs) and 95% CI reported. "

10/01/2009 - "[Prediction of shoulder dystocia--combining foetal weight estimation by ultrasound and maternal risk factors--a solution for the dilemma?]."
12/01/2008 - "Use of standardized forms for shoulder dystocia delivery notes may provide the best solution to ensure appropriate documentation. "
06/01/1999 - "Shoulder dystocia is an infrequent and unexpected emergency requiring rapid and deft solution. "

12/01/2013 - "The neonatal outcome was a composite of preterm delivery, level 3 nursery admission, oxygen requirement >6 h, shoulder dystocia, 5-min Apgar3, umbilical cord arterial pH<7.1 or base excess <-12. "
05/01/2014 - "Primary neonatal outcome was a composite of any of the following: hypoglycemia, preterm delivery, admission to level 3 nursery, oxygen requirement > 6 hours after birth, shoulder dystocia, 5-minute Apgar ≤3, cord pH < 7.0, and cord base excess < -12 mmol/L. "
01/01/2021 - "The primary outcome was a composite of adverse neonatal outcomes, including shoulder dystocia, large for gestational age, neonatal intensive care unit admission, respiratory distress (defined as the need of at least 4 hours of respiratory support with supplemental oxygen, continuous positive airway pressure or ventilation at the first 24 hours of life), or hypoglycemia. "

10/01/2015 - "Women experiencing shoulder dystocia compared with women with uncomplicated deliveries had a higher glycated hemoglobin (HbA1c) in early pregnancy [median 7.0% (range 5.9-8.1) vs. 6.6% (range 5.4-10.0, P = 0.04)], whereas in late pregnancy, HbA1c in the two groups of women was comparable [6.1% (range 5.5-6.9) vs. 6.0% (range 4.7-8.4, P = 0.30)]. "
10/03/2023 - "There were no significant differences in glycemic control and maternal-fetal outcomes between the remote monitoring group and a standard care group, which included glycosylated hemoglobin (HbA1c), fasting blood glucose, mean 2-h postprandial blood glucose, caesarean birth, gestational weight gain, shoulder dystocia, neonatal hypoglycemia, and other outcomes. "
10/15/1985 - "Compared to carbohydrate-tolerant control subjects, gravid patients with carbohydrate intolerance were older, more obese, had higher 1-hour post-50 gm Glucola plasma glucose and glycosylated hemoglobin levels, and infants with increased birth weight percentiles, depressed 5-minute Apgar scores, and an increased incidence of shoulder dystocia and perinatal mortality. "

03/01/2021 - "White 'other' ethnicity (aOR=1.28; 95% CI=1.01 to 1.63); nulliparity (aOR=2.09; 95% CI=1.78 to 2.45); ≥2 previous pregnancies ≥24 weeks' gestation (aOR=1.38; 95% CI=1.10 to 1.74); male sex (aOR=1.46; 95% CI=1.23 to 1.75); maternal pregnancy problem (aOR=1.40; 95% CI=1.03 to 1.90); prolonged (aOR=1.42; 95% CI=1.01 to 2.01) or unrecorded (aOR=1.38; 95% CI=1.05 to 1.81) second stage duration; opiate use (aOR=1.31; 95% CI=1.02 to 1.68); shoulder dystocia (aOR=5.06; 95% CI=3.00 to 8.52); birth weight <2500 g (aOR=4.12; 95% CI=1.97 to 8.60), 4000-4999 g (aOR=1.64; 95% CI=1.25 to 2.14) and ≥4500 g (aOR=2.10; 95% CI=1.17 to 3.76), were independently associated with neonatal admission or mortality. "
12/01/2008 - "Using multivariate logistic regression analysis, significant ante-partum risk factors for PPV-ETT included multiple pregnancy <35 weeks, maternal infection, hypertension, and oligohydramnios; intra-partum factors were preterm delivery at <36 weeks, breech presentation, meconium-stained amniotic fluid (MSAF), non-reassuring fetal heart rate, emergency Caesarean section (EmCS), shoulder dystocia, and opiates in normal labour. "

10/01/1982 - "The results of this study revealed that neonates experiencing shoulder dystocia had significantly greater shoulder-to-head and chest-to-head disproportions than did macrosomic neonates delivered by cesarean section for failed progress in labor or macrosomic neonates delivered without shoulder dystocia. "
01/01/2016 - "Re: Prevention of brachial plexus injury-12 years of shoulder dystocia training: an interrupted time-series study: Posterior arm delivery at the time of caesarean section."
10/18/2006 - "In the first study, there were significantly more caesarean sections in the prophylactic group and when these were included in the results, significantly fewer instances of shoulder dystocia were seen in the prophylactic group (RR 0.33, 95% CI 0.12 to 0.86). "
05/01/1998 - "We sought to test the hypothesis that elective delivery of infants diagnosed with macrosomia by ultrasonographic studies in diabetic women will significantly reduce the rate of shoulder dystocia without significantly increasing cesarean section rate. "
01/01/2023 - "Comparisons include hypertensive disorders, caesarean section, shoulder dystocia and associated harm, induction of labour (IOL), planned birth (PB), early planned birth <39 weeks (EPB), spontaneous labour onset with vaginal birth (SLVB) and medication use. "

12/09/2019 - "Mean scores on the checklist of critical actions improved by 19% for shoulder dystocia and by 27% for neonatal resuscitation. "
10/31/2022 - "%), shoulder dystocia management (51.4 - 88.3%), newborn resuscitation (37.9 - 89.1%), and overall skill score (44.7 - 88.7%), p < 0.0001. "
07/01/2020 - "There is also a need for clinical guidelines that address umbilical cord management when challenging circumstances arise such as breech birth, shoulder dystocia, and the need for resuscitation."
12/09/2019 - "Implementing simulation may improve EM residents' knowledge, confidence, and clinical skills in managing shoulder dystocia and neonatal resuscitation."
12/09/2019 - "All residents increased confidence in managing shoulder dystocia on a five-point Likert scale (1.4 vs 2.8) and 80% increased confidence in performing neonatal resuscitation (1.8 vs 3.0). "

02/01/2018 - "Improved glycemic control allows reducing perinatal morbidity and mortality and, specifically, the risk of macrosomia and shoulder dystocia which are the most common complications associated with GDM. "
01/01/2022 - "For individuals in the stably optimal trajectory group, there were lower risks of cesarean delivery (adjusted relative risk [aRR], 0.93 [95% CI, 0.89-0.96]), shoulder dystocia (aRR, 0.75 [95% CI, 0.61-0.92]), large-for-gestational age (aRR, 0.74 [95% CI, 0.69-0.80]), and neonatal intensive care unit admission (aRR, 0.90 [95% CI, 0.83-0.97]), while for patients in the slowly improving to suboptimal glycemic control trajectory group, risks were higher for cesarean delivery (aRR, 1.18 [95% CI, 1.12-1.24]; (P for trend < .001), shoulder dystocia (aRR, 1.41 [95% CI, 1.12-1.78]; P for trend < .001), large-for-gestational-age (aRR, 1.42 [95% CI, 1.31-1.53]; P for trend < .001), and neonatal intensive care unit admission (aRR, 1.33 [95% CI, 1.20-1.47]; P for trend < .001). "
11/01/2014 - "Three out of four births complicated by shoulder dystocia and BW <4,000 g, occurred in Group 1 (p = 0.076) and were associated with no glycemic control. "
02/01/2013 - "Randomized trials of glycemic control in pregnancies complicated by gestational diabetes reveal decreased rates of macrosomia and shoulder dystocia among those treated. "
12/03/2023 - "Since the risks for macrosomia, shoulder dystocia, and neonatal hypoglycemia are higher in early-onset GDM, these women should undergo strict glycemic control, intensive monitoring, and careful neonatal evaluation."

09/01/2006 - "Following a low forceps delivery, shoulder dystocia was encountered and was unable to be relieved with standard maneuvers. "
05/01/2017 - "This is the first study to demonstrate a statistically significant increase in the rate of shoulder dystocia following rotational forceps birth."
05/01/2021 - "Significant factors that increased the risk of OASI were nulliparity, Asian ethnicity, delivery by forceps or sequential instruments, and shoulder dystocia. "
03/12/2021 - "The comparison with the recent literature suggested that most perinatal OBPP risk factors were within the normal range, although the incidence of shoulder dystocia, forceps and vaginal breech deliveries exceeded the average rates. "
05/01/2017 - "The use of rotational forceps was associated with a statistically significantly higher rate of vaginal birth, but also of shoulder dystocia, compared to manual rotation followed by direct forceps. "

12/01/2005 - "In addition the therapy strategies for shoulder dystocia treatments are momentarily analyzed in scientific discussions. "
12/01/2005 - "In legal medical discussions it is necessary to determine whether there were certain antepartal risks, if diagnosis and therapy were carried out correctly and whether a shoulder dystocia resp. "
01/01/2016 - "Regarding therapy, the US Preventive Task Force concluded in 2013 that GDM treatment significantly reduces the risks of pre-eclampsia, macrosomia and shoulder dystocia (relative risks of 0.62, 0.5 and 0.42, respectively). "
10/01/2022 - "The main outcome was a composite of critically important maternal and perinatal complications (hypertensive disorders of pregnancy, large-for-gestational age neonate, neonatal hypoglycaemia requiring intravenous therapy, shoulder dystocia, perinatal death, neonatal bone fracture and nerve palsy). "
11/01/2013 - "None study evaluating the CCM was detected in pregnant women with GDM Nutritional therapy given during antenatal care was effective in reducing pregnancy complications (preeclampsia, excessive gestational weight gain, necessity for cesarean delivery, for insulin therapy and for shoulder dystocia), perinatal complications (macrosomia, neonatal hypoglycemia, and birth weight) and also in better glycemic control. "