WOMENS-HEALTH Messages for June, 1997: Re: shoulder dystocia

Re: shoulder dystocia

From: Bryan Jick, M.D. (anonymous@obgyn.net)
Thu, 26 Jun 1997 18:35:51 -0500 (CDT)

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Reply: Harvey S. Marchbein, M.D.: "Re: shoulder dystocia"

At Thu, 26 Jun 1997, Joanna wrote: >
>What is shoulder dystocia and what causes it and what ways can it
>manifest itself, other then Erb's palsy? And what is Erb's palsy?

Shoulder dystocia refers to a situation at childbirth. After the baby's head emerges vaginally, the shoulders are the next part to be delivered. Rarely, they are very wide, and get "stuck" behind the woman's pubic bone.

This is an OBSTETRICAL EMERGENCY that ALL OB/GYN should be trained to handle, and prepared to deal with. Usually, with proper maneuvers, the baby can be delivered within a few minutes or less. RARELY, the baby is so STUCK and takes so long to be removed, that it can be DAMAGED.

Erb's palsy is one type of DAMAGE. This is damage to the NERVES on one side of the neck which go to the baby's arm. It is thought to be caused by pulling too hard on the head to deliver it, but it could also be caused by the stuck shoulder problem itself. These babies often have a limp arm after birth, but luckily it usually recovers either fullly or mostly given some time. RARELY, the nerve damage is permanent.

Unfortunately, with a BAD shoulder dystocia, Erb's is not the worst problem. Brain and/or kidney damage from lack of oxygen can occur as well, even the death of the baby. I delivered a baby for a woman, whose first delivery was a home birth with a midwife. Unfortunately, there was a shoulder dystocia, and the baby died. The patient (reluctantly) came to me the second time, but we got her a healthy baby!

Shoulder dystocia can be VERY DIFFICULT to predict. It is often seen in conjunction with BIG babies, Diabetic mothers, and is much higher risk if a woman has had it previously.

Sincerely,

--
Bryan S. Jick, M.D., F.A.C.O.G.
Board-Certified Ob/Gyn
drbryan@earthlink.net

Next message: Bryan Jick, M.D.: "Re: 13weeks / pelvic cavity"
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In reply to: Joanna: "shoulder dystocia"
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