Management of Macrosomia and  Shoulder Dystocia

 

What is shoulder dystocia?

 Shoulder dystocia is a condition that can happen during a vaginal delivery. In shoulder dystocia, the baby’s shoulder gets stuck behind the mother’s pelvic bone as the baby moves down the birth canal to the vagina.This causes the baby to get stuck in the birth canal.

Shoulder dystocia is an emergency that needs to be treated quickly.

 

Do doctors and midwives know when shoulder dystocia is going to happen?

Not usually. But they do know that shoulder dystocia is more likely to happen when a baby is much bigger than normal. Women with diabetes and women who are overweight are more likely to have big babies. It’s also more likely to happen in women who had a baby with shoulder dystocia before.

But most times, shoulder dystocia happens for unknown reasons. Because of this, there is no good way to always prevent it.

What are the symptoms of shoulder dystocia? — Shoulder dystocia causes no symptoms in the mother. During delivery, the doctor or midwife sees that the baby’s shoulders aren’t coming out of the vagina as expected after the baby’s head comes out.

How is shoulder dystocia treated? — As soon as your doctor or midwife sees that there is shoulder dystocia, he or she will have you stop pushing for a while. Then he or she will try different things to help deliver the baby. He or she might:

  •  Move your thighs onto your belly to make more room for the baby
  •  Reach into your vagina to help get the baby unstuck
  •  Press on your belly to push down on the baby’s shoulders and get them unstuck

 

What problems can happen from shoulder dystocia?

Shoulder dystocia can cause problems in both the baby and the mother.

The most common problems that can happen in a baby are:

  •  A broken collarbone
  •  Nerve damage – If the baby’s neck gets stretched too much, the nerves around the shoulder can get damaged. This can cause weakness of the arm and trouble moving the arm. Doctors sometimes use the term “Erb’s palsy” for this type of injury.
  •  A broken arm

The most common problem that can happen in the mother is bleeding from tears in the tissues around the vagina.

 

What if I had a baby with shoulder dystocia before and am pregnant again?

Your doctor or midwife will talk with you about the chances of shoulder dystocia happening again. He or she might recommend that you have a c-section to deliver your baby.

 

 

 

 

Dr. Pinky Ronen, M.D.

950 Threadneedle, Suite 282

Houston, Texas 77079

713-464-4444 phone

713-465-9718 fax

 

 

 

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