Dystocia of shoulder

Shoulder dystocia (SD) refers to the failure of the shoulder to be delivered during childbirth and the need for extra-obstetric maneuvers to facilitate their passage after normal smooth gentle downward traction has failed. Dystocia literally means difficult labour.

The incidence of SD ranges from 0.6% to 3% among cephalic vaginal deliveries.

SD is a clinical diagnosis and the fetal head is applied firmly to the vulva or it may retract after delivery. It shows the characteristic hallmark of turtle sign.

SD results from impaction of the anterior fetal shoulder or less commonly the posterior shoulder on the maternal symphysis pubis or sacral promontory, so the shoulder failed to pass spontaneously. It is a terrifying unpredictable emergency for all healthcare providers worldwide.

  • advanced maternal age
  • abnormal pelvic anatomy
  • short stature
  • maternal diabetes                
  • post date
  • macrosomia
  • prolonged first or second stage of labour
  • improper maneuver (fundal pressure)
  • oxytocin augmentation
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Article information

rID: 30854
System: Obstetrics
Section: Gamuts
Synonyms or Alternate Spellings:
  • Shoulder dystocia
  • Shoulder dystocia (SD)

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