OBJECTIVE DEFINITION OF SHOULDER DYSTOCIA - A PROSPECTIVE EVALUATION

OBJECTIVE: The current study was undertaken to validate the objective definition of shoulder dystocia in a prospectively evaluated group of patients. STUDY DESIGN: Selected vaginal deliveries from January 1995 to December 1996 (N = 722) were evaluated for head-to-body delivery ti me and use of ancillary obstetric maneuvers. Charts were reviewed for perinatal and outcome data. RESULTS: Ninety-nine deliveries were compl icated by shoulder dystocia and 623 deliveries had no shoulder dystoci a. The objective definition described infants with lower 1-minute Apga r scores and increased birth weight. All fetal injuries were in the sh oulder dystocia group. Duration of the second stage was significantly associated with a diagnosis of shoulder dystocia. The risk of shoulder dystocia was increased with maternal diabetes, but it was not correla ted with birth weight in diabetics. CONCLUSIONS: The objective definit ion of shoulder dystocia identified a group of patients with an increa sed birth weight and risk of fetal injuries. The use of an objective d efinition will assist the evaluation of prophylactic and treatment pro posals for shoulder dystocia.