Recurrent shoulder dystocia: is it predictable?

Vered Kleitman, Roi Feldman, Asnat Walfisch, Ronen Toledano, Eyal Sheiner

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Objective: To examine the course and outcome of deliveries occurring in women who previously experienced shoulder dystocia. In addition, recurrent shoulder dystocia risk factors were assessed. Methods: A retrospective cohort analysis comparing all singleton deliveries with and without shoulder dystocia in their preceding delivery was conducted. Independent predictors of recurrent shoulder dystocia were investigated using a multiple logistic regression model. Results: Of the 201,422 deliveries included in the analysis, 307 occurred in women with a previous shoulder dystocia (0.015 %). Women with a history of shoulder dystocia were more likely to be older, experienced higher rates of gestational diabetes mellitus, polyhydramnios, prolonged second stage, operative delivery and macrosomia (>4000 g) in the following delivery. Previous shoulder dystocia was found to be an independent risk factor for recurrent shoulder dystocia (OR = 6.1, 95 % CI 3.2–11.8, p value <0.001) in the multivariable regression analysis. Conclusions: Shoulder dystocia is an independent risk factor for recurrent shoulder dystocia. Deliveries in women with a history of shoulder dystocia are characterized by higher rates of operative delivery, prolonged second stage of labor and macrosomia.

Original languageEnglish
Pages (from-to)1161-1166
Number of pages6
JournalArchives of Gynecology and Obstetrics
Volume294
Issue number6
DOIs
StatePublished - 1 Nov 2016
Externally publishedYes

Keywords

  • Cephalo-pelvic disproportion
  • Macrosomia
  • Obesity
  • Recurrent shoulder dystocia
  • Shoulder dystocia

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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