Consortium on Safe Labor

Eunice Kennedy Shriver National Institute Of Child Health & Human Development

Investigators

Linked publications & trials

Abstract

In the previous year, researchers investigated maternal and neonatal outcomes in pregnancies complicated by shoulder dystocia. Both composite maternal and neonatal adverse outcomes were significantly higher following shoulder dystocia than without it. Researchers also sought to ascertain if the risk factors associated with shoulder dystocia can predict if the delivery will be complicated by impacted shoulder. The receiver-operating characteristic curves indicated that neither the antepartum maternal characteristics nor the intrapartum course were clinically useful in identifying which vaginal birth would be complicated by shoulder dystocia. Though the duration of second stage of labor differed among those with composite maternal and neonatal morbidity, its clinical utility and application remain uncertain. These findings underscore that prediction based on risk factors is not possible. With the perceived increase in the rate of shoulder dystocia over the last half century, it is important for providers caring for women in labor to be aware of the increased rate of maternal complications associated with shoulder dystocia and be prepared to manage them. Simulation exercises for shoulder dystocia should focus on prevention and management of both maternal and neonatal complications. (Mendez-Figueroa H et al. American Journal of Obstetrics & Gynecology MFM, 2021) Collectively, this body of research continues to provide data useful for the ongoing development of clinical guidance regarding the management of contemporary pregnant women. The data is publicly available via the NICHD DASH website, https://dash.nichd.nih.gov/.