Shoulder Dystocia: A Pregnancy Emergency
Distocia de Hombros: Emergencia de Embarazo
If you've been following along over on Instagram then you know I've been sharing what it's like to be on call over the weekend! If you're not following, then follow me here! This weekend has been INSANELY busy (full moon anyone?!), I've treated everything from severe preeclampsia, uncontrolled diabetes, emergency c-sections, postpartum hemorrhages, preterm labor--honestly you name it! I mentioned in my stories that I had a Shoulder Dystocia and so many of you had questions about it! Many asked about what this was, but a lot of you also shared your personal stories with having a shoulder dystocia. So, I knew I had to write a blog post on it! Let's get started!
Si has estado siguiendo en Instagram, entonces sabes que he estado compartiendo cómo es estar de guardia durante el fin de semana! Si no me estás siguiendo, ¡sígueme aquí! Este fin de semana ha estado INCREÍBLEMENTE ocupado, He tratado de todo, desde preeclampsia grave, diabetes no controlada, cesáreas de emergencia, hemorragias posparto, trabajo de parto prematuro, ¡honestamente lo que sea! ¡Mencioné en mis stories que tuve un case de distocia de hombros y muchos de ustedes tenían preguntas al respecto! Muchos preguntaron qué era esto, pero muchos de ustedes también compartieron sus historias personales sobre la distocia de hombros. Entonces, ¡sabía que tenía que escribir una publicación de blog sobre eso! ¡Empecemos!
+ what is it?
A shoulder dystocia is a pregnancy emergency that is unpredictable and unpreventable. It can lead to significant injury to both the mother and the baby. A shoulder dystocia occurs when the baby's head delivers but the shoulders get stuck behind the mom's pelvic bones. Typically, after the fetal head delivers, the shoulders and body should deliver with gentle downward traction on the fetal head, when this doesn't happen a shoulder dystocia is diagnosed.
+ how do we fix it?
We are trained extensively in shoulder dystocia as OBGYNs. There are several maneuvers we can try in order to safely deliver the baby. It is an emergency so we need to act quickly in order to deliver baby as safely as possible.
+ what causes it?
Incidence is anywhere from 0.2 - 3%. Here's a list of conditions that can potentially lead to a shoulder dystocia: large baby (especially when the baby's abdomen is bigger than the head!), mom is a diabetic (especially if her sugars are not well controlled) and history of a previous shoulder dystocia. The chance of reoccurrence if you've had a previous shoulder dystocia is anywhere form 1-16.7%.
+ the maternal complications
Shoulder dystocia can eventually lead to problems for the mom. These include an increased risk of postpartum hemorrhage (if you don't know what this is, I've written a blog post about it here) and increased risk of complicated vaginal tears (I have a YouTube video about vaginal tearing during childbirth here!). If it's a very complicated shoulder dystocia it may lead to an emergency surgery which can cause multiple issues to the mother as well!
+ the baby complications
Luckily, most shoulder dystocias are corrected and leave the baby without any injuries, but that may not always be the case. Here are some of the potential complications that can be seen: brachial plexus injury or fracture of the clavicle or bones in the arms. Thankfully a lot of these babies recover from these injuries without any lifelong complications.
+ my recommendations
If you've had a shoulder dystocia in a previous pregnancy you HAVE to let us know. If you haven’t already, download my free pregnancy guide and you can write it down in there! We want to try our best to prevent this from happening again, so it's a good conversation to have with your doctor. Some women who have had very traumatic shoulder dystocias may opt for having a c-section in the following pregnancy. Definitely a conversation you want to have with your medical provider!