Shoulder Dystocia

Format Publication ID Version Published
Case 8228 1 March 17, 2011
University of Washington School of Medicine

Description

Shoulder dystocia is an obstetric emergency complicating 0.3-1% of all deliveries, and can lead to permanent disability or death of the neonate, and on occasion, serious morbidity of the mother. Though frequently associated with higher birth weights, 50% of shoulder dystocias occur in normally grown neonates, making prediction of shoulder dystocia difficult. Shoulder dystocia occurs when descent of the neonate’s anterior shoulder is obstructed by the mother’s pubic symphysis and on occasion when the posterior shoulder is obstructed by the sacral promontory. Because this emergency can occur unpredictably with any pregnancy, all delivery attendants must have an understanding and a management plan for this obstetric emergency.

This course is designed to give obstetric care providers an opportunity to train and practice the hand movements required to manage a shoulder dystocia. As severe shoulder dystocia is an uncommon event, a provider may go years without a real-life experience. Safe delivery of an infant suffering a shoulder dystocia requires several crucial steps. Learners in this course will 1) appropriately identify shoulder dystocia, 2) call needed back-up support, 3) communicate the situation to the mother, 4) perform the steps to relieve the shoulder dystocia, and 5) accurately document the event.

Citation

Fialkow M, Benedetti T, Kim S. Shoulder Dystocia. MedEdPORTAL; 2011. Available from: www.mededportal.org/publication/8228

Educational Objectives

  1. To identify a shoulder dystocia, and recognize a need for assistance.
  2. To modify and apply new knowledge to deliveries complicated by shoulder dystocia.
  3. To formulate a mental checklist of maneuvers and appropriate help.
  4. To identify components of communication with a patient.
  5. To identify aspects of the simulation that were both successful, and need improvement.
  6. To evaluate his/her performance during the simulation event by completing a self-assessment.
  7. To document the shoulder dystocia for the medical record, recording the key maneuvers, personnel present, and outcome of the patients.
  8. To demonstrate components of communication which have demonstrated improvement in patient outcomes.

Keywords

  • Shoulder Dystocia, Parturition (MeSH), Birth Complications

Specialty

  • Medical
    • Critical Care Medicine
    • Maternal & Fetal Medicine
    • Obstetrics & Gynecology

Competencies Addressed

  • Medical
    • Interpersonal & Communication Skills
    • Medical Knowledge
    • Patient Care
    • Practice-based Learning & Improvement
    • Professionalism
    • Systems-based Practice

Academic Focus

  • Clinical Sciences
    • Clinical Exam
    • Clinical Skills/Doctoring

Intended Audience

  • Professional School
    • Medical Student
  • Professional School Post-Graduate Training
    • Resident

Instructional Methods

  • Simulation

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