Delivery Complications

Question 1

What is shoulder dystocia?

Answer 1

occurs due to impaction of the anterior fetal shoulder on the maternal pubic symphysis

Question 2

What are RFs of shoulder dystocia?

Answer 2

fetal macrosomia (hence association with maternal diabetes mellitus)
high maternal body mass index
diabetes mellitus
prolonged labour

Question 3

How is shoulder dystocia managed?

Answer 3

1. Call senior help as soon as it is identified
2. McRoberts’ manoeuvre - flexion and abduction of the maternal hips, bringing the mother’s thighs towards her abdomen. increases the relative anterior-posterior angle of the pelvis and often facilitates a successful delivery.

Question 4

What are complications of shoulder dystocia?

Answer 4

maternal
postpartum haemorrhage
perineal tears

fetal
brachial plexus injury
neonatal death

Question 5

What are RFs for transverse lie?

Answer 5

Most commonly occurs in women who have had previous pregnancies
Fibroids and other pelvic tumours
Pregnant with twins or triplets
Prematurity
Polyhydramnios
Foetal abnormalities