shoulder dystocia
Obstetric emergency occurring when fetal shoulders become impacted behind maternal symphysis pubis after delivery of the head.
Full Definition
Shoulder dystocia is an unpredictable obstetric emergency that occurs when the fetal anterior shoulder becomes impacted behind the maternal symphysis pubis after delivery of the fetal head, requiring additional obstetric maneuvers for delivery. The condition affects 0.5-3% of vaginal deliveries and is associated with macrosomia, maternal diabetes, prolonged second stage of labor, and operative vaginal delivery. Complications include brachial plexus injury (Erb's palsy), clavicular or humeral fractures, fetal hypoxia, and maternal trauma including uterine rupture or severe lacerations. Management involves a systematic approach including the HELPERR mnemonic: call for Help, Evaluate for Episiotomy, Legs (McRoberts position), Pressure (suprapubic), Enter (internal maneuvers), Remove posterior arm, and Roll to hands and knees.
Usage
Usage note: Document specific maneuvers used and time to resolution for medicolegal purposes.
In Context
- "Shoulder dystocia was successfully resolved using McRoberts maneuver and suprapubic pressure without fetal injury." — Delivery summary note
- "The 4200-gram infant experienced shoulder dystocia requiring internal rotation maneuvers and episiotomy for safe delivery." — Labor and delivery documentation