- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Proportions between fetal head and abdominal circumference good predictors of Shoulder Dystocia
Shoulder dystocia (ShD) is the inability to deliver the baby's shoulders naturally. The condition affects approximately 0.15% to 3% of vaginal deliveries. Although most newborns recover from this without permanent harm, up to 20% of cases may result in temporary injuries such as brachial plexus damage, fractures, and hypoxic-ischemic encephalopathy. Maternal complications, including perineal damage, postpartum haemorrhage, and mental stress, can also arise from shoulder dystocia.
A recent study published in the International Journal of Gynecology and Obstetrics has concluded that operative vaginal delivery, vaginal birth after cesarean (VBAC) and sonographic proportions between the abdominal circumference (AC) and fetal head are independently associated with ShD. Researchers in this study highlighted that women with these factors should get attention.
This study included women with neonatal birthweight <3500g. researchers compared cases of ShD to other deliveries and analyzed risk factors for ShD among women delivering <3500g newborns. This was a retrospective case–control study of all term live-singleton deliveries (2011–2019).
Key findings from this study are:
- There were 0.19% ShD cases among neonates <3500 g.
- The factors independently associated with ShD included operative vaginal delivery, VBAC, sonographic abdominal circumference to biparietal diameter ratio (3.73 among ShD vs. 3.62,) and sonographic abdominal circumference to head circumference ratio (1.036 among ShD vs. 1.011).
- The OR were 2.78, 2.74, 1.35 and 3.04 respectively.
They said, "Our study is the largest study addressing ShD among neonates weighing <3500 g. The proportions between the fetal head and abdominal circumference better predict ShD than the newborn fetal weight, and VBAC is associated with ShD."
A previous study conducted over three decades ago, focusing on an American population, reported a ShD rate of 0.5% among neonates weighing less than 3500 g.
The present study had limitations like retrospective design, limited power of sample size, inherent bias, and selection bias.
Reference:
Levin, G., Meyer, R., Cahan, T., Shai, D., & Tzur, A. (2023). Shoulder dystocia in delivery of neonates <3500 grams. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/ijgo.15204
MBBS, MD Obstetrics and Gynecology
Dr Nirali Kapoor has completed her MBBS from GMC Jamnagar and MD Obstetrics and Gynecology from AIIMS Rishikesh. She underwent training in trauma/emergency medicine non academic residency in AIIMS Delhi for an year after her MBBS. Post her MD, she has joined in a Multispeciality hospital in Amritsar. She is actively involved in cases concerning fetal medicine, infertility and minimal invasive procedures as well as research activities involved around the fields of interest.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751