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Re: Shoulder dystociaFrom: ainsron@msn.comMon Mar 13 09:43:11 2000
Dan, I have a similar situation, 31 yo, G3 P2, 1st delivery uneventful, 3378gm (7# 7oz), SVD; 2nd delivery was 4794gm (10# 9oz) @ 40 weeks, severe shoulder dystocia with fractured clavicle. Fortunately the infant recovered without long-term neurologic complications. She was screen negative for DM at beginning of pregnancy and 28 weeks, and is now at 34 weeks. She has been LGA since 28 wks, Sono at 9 wks and 22 wks were consistent with dates, but sono at 30 wks was 2wks ahead of dates, +90th percentile. She and her husband are anxious about this delivery, as I am (I didn't do her last delivery), and if a sonogram at 37-38 weeks confirms continued size>>dates, we will probably schedule a C/S. >Hi, >Here is a case to follow up on the recent thread of Shoulder Dystocia. A 29 y/o G3 P2, two prior vaginal deliveries handled by my FP partner down the hallway. First baby, just over 4000 gms, born at 41 wks, complicated by shoulder dystocia, which resolved with McRoberts and an episiotomy. Second baby, induced at 38 wks in order to avoid the history of the first delivery, resulted in another case of shoulder dystocia, this one needing Wood's screw in addition to the other moves. Interesting item--birth weight 3490 gms.--for baby #2. Baby #2 gave just a few gray hairs to my partner. By his description, that one was the worst case case he has been through. > >Patient is now in third trimester with baby # 3. Since I'm an OB, I think I can handle this case better than my partner. I'll induce her on Wednesday at 38 1/2 wks. You need to have commitment for vaginal delivery. > >-- >------ >------- >------ >--------- >------- >JUST KIDDING. The patient is scheduled for C/S on Wednesday. I have a feeling that Geff Klein would personally drive to South Dakota and break my clavicle if I tried to delivery this patient from below. > >Dan Flaherty MD >Watertown SD >
-- Ronald E. Ainsworth, MD
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