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Semin Perinatol. 2007 Jun;31(3):185-95.

After shoulder dystocia: managing the subsequent pregnancy and delivery.

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  • 1Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.


Among risk factors for shoulder dystocia, a prior history of delivery complicated by shoulder dystocia is the single greatest risk factor for shoulder dystocia occurrence, with odds ratios 7 to 10 times that of the general population. Recurrence rates have been reported to be as high as 16%. Whereas prevention of shoulder dystocia in the general population is neither feasible nor cost-effective, intervention efforts directed at the particular subgroup of women with a prior history of shoulder dystocia can concentrate on potentially modifiable risk factors and individualized management strategies that can minimize recurrence and the associated significant morbidities and mortality.

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