Can Shoulder Dystocia be Prevented? What are the Risk Factors and What Happens if This Occurs During
Minimizing risk factors like induction of labor in a known macrosomic baby is one thing that can be done. Obstetricians are also trained to recognize risk factors during labor that may be a tip off to shoulder dystocia, but again I re-iterate that there is no definite way to predict or prevent all cases of shoulder dystocia, and we are exquisitely trained to recognize and respond to cases of shoulder dystocia.
Other risk factors are excessive maternal weight gain, maternal obesity, maternal diabetes, prior baby with shoulder dystocia, postdates pregnancy, prolonged second stage of labor (when the mother is pushing), and operative vaginal delivery.
If a shoulder dystocia occurs, the greatest likelihood is that your obstetrician will be able to safely correct the situation for you and your baby. When a shoulder dystocia is recognized your doctor may call other people into the room to help such as other obstetricians for assistance, nurses, and an anesthesiologist.
Your legs will be taken out of the footrests and your thighs pulled back to be flexed on your abdomen. An assistant will provide pressure over your pubic bone (not at the top of your uterus- that can make the dystocia worse), and your doctor may perform maneuvers to get around the anterior shoulder like delivering the posterior arm of the baby first or doing certain rotational maneuvers.
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