Analysis of emergency management of shoulder dystocia in 16 cases

Abstract

Objective Analyze the characteristics of shoulder dystocia and reduce the complications of maternal and neonatal. Methods Clinical data of 16 cases of shoulder dystocia, who were admitted in the Obstetrics Department of the First Affiliated Hospital of the Army Military Medical University from January 2013 to December 2018, were retrospective analysis. The analysis indicators included high risk factors of shoulder dystocia, diagnosis of shoulder dystocia, assisted delivery methods and the maternal and fetal outcomes. Results There were 16 252 cases of raginal delivery and 16 cases of dystocia of shoulder within 6 years, the incidence was 0.1%. Among the 16 patients with shoulder dystocia, 3 cases gave birth to giant babies, 4 cases were gestational diabetes, 5 cases were assisted delivery with instruments, and the other 4 cases had no high risk factors. 7 cases of shoulder dystocia were diagnosed as shoulder impaction after delivery of fetal head, 9 cases were diagnosed as shoulder impaction after delivery of fetal head and combined with tortoise sign . Sixteen cases were treated with 3-5 steps of seven steps in the management of shoulder dystocia and then finally delivered the baby through vagina. Maternal and infant outcomes: 1 case were postpartum hemorrhage, 11 cases were lateral episiotomy, 9 cases were soft birth canal injury, no body had serious perineal laceration; 14 newborns were good health, 1 newborn were found ptosis at 3 months old and 1 case lost visit. Conclusions Shoulder dystocia is still an unpredictable obstetric emergency. It is necessary to correctly judge the occurrence of shoulder dystocia, master the treatment process of shoulder dystocia, and quickly rescue, so as to reduce the complications of mother and child. Key words: Shoulder dystocia; High risk factors; Complications