Shoulder Dystocia
Publication Date: April 30, 2017
Last Updated: March 14, 2022
Recommendations
Although there are a number of known risk factors, shoulder dystocia cannot be accurately predicted or prevented. Clinicians should be aware of the risk factors for shoulder dystocia in order to anticipate those deliveries at high risk and should be prepared to address this complication in all deliveries. ( B )
574
Elective cesarean delivery should be considered for women without diabetes who are carrying fetuses with suspected macrosomia with an estimated fetal weight of at least 5,000 g and for women with diabetes whose fetuses are estimated to weigh at least 4,500 g. (B)
574
When shoulder dystocia is suspected, the McRoberts maneuver should be attempted first because it is a simple, logical, and effective technique. (B)
574
Contemporaneous documentation of the management of shoulder dystocia is recommended to record significant facts, findings, and observations about the shoulder dystocia event and its sequelae. (B)
574
Simulation exercises and shoulder dystocia protocols are recommended to improve team communication and maneuver use because this may reduce the incidence of brachial plexus palsy associated with shoulder dystocia. (B)
574
In cases where the McRoberts maneuver and suprapubic pressure are unsuccessful, delivery of the posterior arm can be considered as the next maneuver to manage shoulder dystocia. (C)
574
Recommendation Grading
Overview
Title
Shoulder Dystocia
Authoring Organization
American College of Obstetricians and Gynecologists
Publication Month/Year
April 30, 2017
Last Updated Month/Year
April 1, 2024
Document Type
Consensus
External Publication Status
Published
Country of Publication
US
Health Care Settings
Emergency care, Hospital
Intended Users
Physician, nurse midwife, nurse, nurse practitioner, physician assistant
Scope
Management
Diseases/Conditions (MeSH)
D004420 - Dystocia, D000080883 - Shoulder Dystocia
Keywords
dystocia, shoulder dystocia