Risk factors and neonatal outcomes in shoulder dystocia

Background. Shoulder dystocia (SD) is a rare obstetrical complication but linked with a high perinatal morbidity and mortality rate. SD has been associated to a series of maternal and fetal risk factors due to a multifactorial etiology. This study analyzes the incidence of SD, its morbidity and associated risk factors. Methods. Cases of SD occurred at the St. Gerardo Hospital (Monza) between January 1992 trough December 1997 have been retro-spectively reviewed. Obstetrical and feto-neonatal data regarding cases of SD were compared to data regarding all the cephalic vaginal deliveries occurred in the same period in our Center. Results. A total of 14,157 cephalic vaginal deliveries were included in this study, of these 21 infants (0.15%) had SD. A significantly higher incidence of SD cases was found in fetal macrosomia, maternal diabetes, induction of labor by PGE2, use of obstetrical vacuum, length of first stage of labor >4 hours in multiparas and >8 hours in nulliparas, and length of ...