Dystocia is a term used to describe the difficult labor and delivery of a baby. In shoulder dystocia, the baby's head can be delivered but the shoulders can't pass through the birth canal. The shoulders are too wide to fit, and become lodged behind the mother's pubic bone or the opening of the birth canal.
Typically, babies born with shoulder dystocia don’t suffer long-term complications. If complications do occur, they are usually because the baby has become stuck too long in the birth canal.
Complications to the baby include lack of oxygen; broken arm or collarbone; nerve damage or paralysis. Complications to the mother include tearing or bruising of the cervix, rectum, or vagina. Bruising to the bladder and hemorrhaging may also occur.
If babies are delivered quickly and are not stuck in the birth canal for a long period of time, complications to the mother and fetus are unlikely.
There are a variety of reasons why a baby's shoulders may become lodged during delivery, but the most common reasons for shoulder dystocia include:
-
Delivering very large babies with unusually high birth weights
-
Usually caused by
diabetes
or mothers who are significantly overweight
- Mother's pelvic opening being too small to allow the baby's shoulders to fit
A risk factor is something that increases your chance of getting a disease or condition.
The following factors increase the chance of a baby suffering from shoulder dystocia:
- Mothers who are diabetic
- Mothers who are significantly overweight
- Mothers, often small themselves, who may have a small pelvic bone
The signs of shoulder dystocia become apparent during delivery, when labor does not progress because of the baby's shoulders being lodged in the birth canal behind the pubic bone. Signs also include very large babies who are likely to have problems being delivered vaginally.
. Shoulder dystocia cannot actually be diagnosed until delivery, but it can be predicted by determining the weight and size of the fetus and whether a vaginal delivery is safe for the mother and baby. An
ultrasound
maybe performed prior to labor in an attempt to determine if the baby is too large to fit safely through the birth canal during delivery.
Your doctor will decide on the best treatment plan for you. Treatment options include:
For babies who experience shoulder dystocia and cannot complete a vaginal delivery using a standard series of maneuvers requiring the cooperation of the mother, a
Cesarean delivery
will be performed. For babies who are at risk of shoulder dystocia because of their large size, a Cesarean delivery may be scheduled.
While shoulder dystocia cannot be prevented, babies who are at risk of shoulder dystocia because of large birth weight can be evaluated prior to delivery with regular prenatal care and ultrasound testing.
Women with diabetes or who are very overweight should have the size of their babies estimated, and babies at risk for shoulder dystocia should have a Cesarean delivery scheduled.
