Shoulder dystocia: prevention and treatment

Article Abstract:

Although shoulder dystocia occurs in less than 1 percent of births, studies have reported that the rate of shoulder dystocia is increasing. The condition occurs during delivery. In shoulder dystocia the infant stops moving after the head has emerged;this is potentially very serious, and can result in damage to the infant if the response is not prompt and correct. To reduce the rate of shoulder dystocia, physicians should monitor pregnant women for possible risk factors: a history of shoulder dystocia, pre-existing or gestational diabetes, maternal obesity, abnormal pelvic size and shape, and a large fetus, regardless of the cause. It is interesting to note that the mother's own weight at her birth is a more significant risk factor than her present weight, and a careful medical history should record this fact. If shoulder dystocia is recognized as a possibility, the clinician may be prepared to respond quickly and positively, as there can be no hesitation once the situation is recognized. If the situation is sufficiently grim, or the risk factors are judged to be serious cesarean section is the only alternative. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Birth weight, Obstetrics, Labor, Complicated, Labor complications, Birth size, Obstetrical surgery

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Controlled cord traction versus minimal intervention techniques in delivery of the placenta: a randomized controlled trial

Article Abstract:

There appear to be fewer complications associated with a controlled method for delivering the placenta compared to a more natural method. Post-delivery complications were documented among 1,648 vaginal births with either a manually and chemically assisted placenta delivery or by allowing the mother to push the placenta out. Assisted placenta deliveries resulted in less extensive blood loss, less need for medications to control blood loss, and fewer instances of delayed placenta delivery compared to minimally assisted placenta deliveries.

Prevention, Physiological aspects, Labor (Obstetrics), Placenta, Puerperal disorders

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Translating data to dialogue: How to discuss mode of delivery with your patient with twins

Article Abstract:

The epidemiologic data with regard to the increased morbidity and mortality of the second twin on the basis of mode of delivery for a patient with twins is translated into the number needed to treat to prevent one adverse outcome and these numbers are compared with other indications for primary cesarean delivery. It is concluded that the translation of the odds risk assessment into the number needed to treat is more useful in patient counseling on the mode of delivery of twins.

United States, Management dynamics, Practice, Company business management, Pregnancy, Multiple, Multiple pregnancy, Gynecologists

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