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Arch Gynecol Obstet. 2016 Nov;294(6):1161-1166. Epub 2016 Jun 23.

Recurrent shoulder dystocia: is it predictable?

Author information

1
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. veredkl@gmail.com.
2
Department of Obstetrics and Gynecology, Soroka University Medical Center, 151 Izak Rager Ave, 84101, Beer-Sheva, Israel. veredkl@gmail.com.
3
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
4
Clinical Research Center, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Abstract

OBJECTIVE:

To examine the course and outcome of deliveries occurring in women who previously experienced shoulder dystocia. In addition, recurrent shoulder dystocia risk factors were assessed.

METHODS:

A retrospective cohort analysis comparing all singleton deliveries with and without shoulder dystocia in their preceding delivery was conducted. Independent predictors of recurrent shoulder dystocia were investigated using a multiple logistic regression model.

RESULTS:

Of the 201,422 deliveries included in the analysis, 307 occurred in women with a previous shoulder dystocia (0.015 %). Women with a history of shoulder dystocia were more likely to be older, experienced higher rates of gestational diabetes mellitus, polyhydramnios, prolonged second stage, operative delivery and macrosomia (>4000 g) in the following delivery. Previous shoulder dystocia was found to be an independent risk factor for recurrent shoulder dystocia (OR = 6.1, 95 % CI 3.2-11.8, p value <0.001) in the multivariable regression analysis.

CONCLUSIONS:

Shoulder dystocia is an independent risk factor for recurrent shoulder dystocia. Deliveries in women with a history of shoulder dystocia are characterized by higher rates of operative delivery, prolonged second stage of labor and macrosomia.

KEYWORDS:

Cephalo-pelvic disproportion; Macrosomia; Obesity; Recurrent shoulder dystocia; Shoulder dystocia

PMID:
27338567
DOI:
10.1007/s00404-016-4139-1
[Indexed for MEDLINE]

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