SHOULDER DYSTOCIA
Shoulder dystocia, which is a medical emergency, occurs when a baby's shoulder becomes lodged behind the mother's pelvis during labour. Excessive traction used in the delivery of the child can damage the ‘brachial plexus’ network of nerves which runs from the spine, across the shoulders to the tips of the fingers. Failing to remedy this problem can result in asphyxiation and death. Doctors and midwives attending a birth should be familiar with the well established protocols which if applied appropriately will relieve the problem. The methods of dealing with this serious problem include:
- repositioning the mother
- manoeuvring and changing the baby’s position
- carrying out the McRobert's manoeuvre
- breaking the mother's pelvic bone
- applying pressure to the pubic area
- emergency caesarean section
- breaking the baby's clavicle bone on purpose
- deep episiotomy cut
- applying traction in a horizontal plane
Damage to the brachial plexus nerves can manifest itself in a number of different ways ranging from mild to severe and from temporary to permanent. The injury is usually classified as follows:
- Klumpke's Palsy - Usually includes a limp hand and immobile fingers often associated with Horners syndrome.
- Complete Brachial Plexus Palsy - Occurs when the entire arm is paralysed. There may also be Horner's Syndrome and Torticollis caused as a result of nerve damage.
- Erbs Palsy - Is characterised by the arm being turned towards the body, with a stiff elbow and the hand in a ‘waiters tip’ position.
IMPORTANT NOTICE
This website is for information only and does not contain medical or legal advice which should only be obtained from a qualified professional person. This website does not recommend any individual medical or legal professionals and does not refer matters on to any medical or legal professionals. This website is not intended to endorse any person, association or firm.
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