Brow presentation usually converts spontaneously to vertex or face presentation. The 2nd most common abnormal presentation is breech (buttocks before the head). [msdmanuals.com]

CASE PRESENTATION: A 23-year-old Sukuma woman, gravida 2, para 1 presented to an maternity emergency unit of Sengerema Designated District hospital at a gestation age of 35(+5) weeks as a referral from a rural health center due to arrested descent despite [ncbi.nlm.nih.gov]

• Nightmare

  Shoulder dystocia is the unpredictable and unpreventable nightmare of the obstetrician. We report a case of spontaneous pubic symphyseal separation, the first reported case to result in the resolution of shoulder dystocia. [ncbi.nlm.nih.gov]

  Shoulder dystocia: an evidence-based evaluation of the obstetric nightmare. Clin Obstet Gynecol. 2002 Jun. 45(2):345-62. [Medline]. Allen R, Sorab J, Gonik B. Risk factors for shoulder dystocia: an engineering study of clinician-applied forces. [emedicine.medscape.com]

• Hunting

  Crofts JF, Bartlett C, Ellis D, Hunt LP, Fox R, Draycott TJ. Management of shoulder dystocia: skill retention 6 and 12 months after training. Obstet Gynecol. 2007 Nov. 110 (5):1069-74. [Medline]. [emedicine.medscape.com]

• Musculoskeletal Pain

  Consider a physiotherapist review before discharge, as women are at increased risk of pelvic floor weakness/3rd degree tear, musculoskeletal pain and temporary nerve damage. [teachmeobgyn.com]

• Urinary Incontinence

  Maternal morbidity including urinary incontinence was significant but responded to treatment. [ncbi.nlm.nih.gov]

Maternal morbidity including urinary incontinence was significant but responded to treatment. [ncbi.nlm.nih.gov]

The chart below lists the suggested treatment techniques for each stage or grade of shoulder dystocia. Stage Treatment Techniques I. Mild Suprapubic Pressure (with or without rotation) Woods Screw Maneuver Rubin Maneuver II. [birthinjuryhelpcenter.org]

PURPOSE: To describe the risk factors and labor characteristics of Clavicular fracture (CF) and brachial plexus injury (BPI); and compare antenatal and labor characteristics and prognosis of obstetrical BPI associated with shoulder dystocia with obstetrical [ncbi.nlm.nih.gov]

Risk factors advanced maternal age abnormal pelvic anatomy short stature maternal diabetes post dates macrosomia prolonged first or second stage of labor improper maneuver (fundal pressure) oxytocin augmentation Treatment and prognosis Complications Maternal [radiopaedia.org]

Prognosis : guarded to good. Pathogenesis Etiology Maternal vs Fetal (see above); combination of maternal and fetal causes most common. [vetstream.com]

The thickness of cerebral cortex which determines postpartum prognosis of the foetus can be measured by ultrasound. Complications Obstructed labour: with its sequel as rupture uterus. [gfmer.ch]

The prognosis of birth traumas is usually favorable, with most injuries resolving spontaneously within weeks to months. [amboss.com]

Geometric analysis reveals that borderline adequate pelvimetry likely played a significant role in severe shoulder dystocia etiology, even with a small-for-gestational-age infant. [ncbi.nlm.nih.gov]

Pathogenesis Etiology Maternal vs Fetal (see above); combination of maternal and fetal causes most common. Pathophysiology Deviation from normal labor Stages of normal labor First : uterine contractions increasing in frequency and duration. [vetstream.com]

[…] of 100% oxygen.[5][6] There is considerable controversy over the diagnosis of birth asphyxia due to medicolegal reasons.[7][8] Because of its lack of precision, the term is eschewed in modern obstetrics.[9] Cause[edit] Basically, understanding of the etiology [en.wikipedia.org]

Epidemiology Shoulder dystocia occurs in 0.58-0.70% of vaginal deliveries.[1] Aetiology These may be remembered as 'The Powers' (uterus), 'The Passenger' (fetus) and 'The Parts' (pelvis). [patient.info]

Pathophysiology Deviation from normal labor Stages of normal labor First : uterine contractions increasing in frequency and duration. Normally 12-24 h in duration. [vetstream.com]

The general principles guiding the causes and the pathophysiology of perinatal asphyxia are grouped into antepartum causes and intra partum causes. As these are the various points to which insults can occur to the foetus. [en.wikipedia.org]

(Please refer to the Pathophysiology for information regarding adequate contractions.) Abnormal labor constitutes any findings that fall outside the accepted normal labor curve. [emedicine.medscape.com]

Pathophysiology: To characterize a labor as abnormal, a basic understanding of normal labor is necessary. Normal labor starts with regular uterine contractions that are sufficient enough to result in cervical effacement and dilation. [www1.cgmh.org.tw]

Pathophysiology of uterine contractions in obstructed labour The obvious purpose of labour is to deliver the fetus and then placenta, whether the labour becomes obstructed or not. [doi.org]

As a result, the prediction of shoulder dystocia remains elusive, and the cost of trying to prevent one by performing a cesarean delivery remains high. [ncbi.nlm.nih.gov]

Data are too limited to support or refute the use of prophylactic manoeuvres for the prevention of shoulder dystocia. RHL Commentary by Melo B 1. [extranet.who.int]