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Re: shoulder dystocia

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Mon, 25 Oct 1999 21:31:04 -0500 (CDT)


At Sun, 24 Oct 1999, Sandi wrote: >
>During the birth of my second child, there was shoulder dystocia. His
>head delivered after only 3 pushes, but his shoulders got stuck. My OB
>pulled him out. Luckily, so I'm told, my son suffered only temporary
>nerve damage to his shoulder and a broken humerous. He was 8lbs. 12
>oz. at birth. Today he is a perfectly (if that is possible) healthy,
>normal 4 year old! I am now pregnant with my third child. An ultrasound
>for EFW showed my baby to be approx. 6.5lbs at 36 weeks. I guess this
>is bigger than normal, because now my OB is insisting that I deliver by
>c-section to avoid any potential problems at birth. I am very upset by
>this. I believe that the safest birth for both mother and child is a
>natural birth, and I want to be able to deliver naturally. I'm told
>that shoulder dystocia is unpredicable and it would not be wise to take
>the chance that this could happen again. I can not find any research
>that shows that a previous shoulder dystocia is indication that this
>complication will reoccur. Any advice, research suggestions or
>comments? (my first child was 8lbs. 6oz. born with no complications)
>
>Thank you.
>Sandi.

EFW for this one sounds like it wil be the same as the last one, maybe a little bigger, maybe a little smaller but in the same ballpark.

There is no literature I'm aware of which recommends C/S for prevention of shoulder dystocia unless the baby is macrosomic (larger than 9#) and even that is debatable.

You're right, however. Shoulder dystocia is very unpredictable. There is no right or wrong answer. Good luck in your deliberations.

--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York

**Note: Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.

**Private emails cannot be entertained due to time constraints, consequently no private emails will receive a response.

**Thank you for your understanding ;-)






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