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9 Cards in this Set
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- Back
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Definition of Shoulder Dystocia
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occurs when the anterior shoulder becomes impacted against the symphysis pubis and the shoulders do not deliver with usual manoeuvers.
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Incidence of Shoulder dysocia
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Overall 0.2-2%
If fetal weight is >4Kg: 4% If fetal weight is >4.5Kg: 10% higher for diabetic mothers delivering large babies |
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Factors associated with Should Dystocia(6)
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Post Term pregnancy
suspected fetal macrosomia Prolonged Labour Previouls shoulder dystocia Oxytocin auguemtation operative deliveries |
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Complications associated with Shoulder dystocia (7)
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clavicle and humerus fractures
brachial plexus injuries hypoxia/asphyxia PPH lacerations uterine rupure infection |
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Normal Mechanism of Shoulder Delivery
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after delivery of head, shoulders rotate to antero-posterior diameter allowing for the widest diameter of the shoulders to be in line with the widest diameter of the outlet
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How to identify shoulder dystocia
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fetal head retracts against the perineum
cyanosis of the fetal head restitution rarely takes place |
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Mnemonic for shoulder dystocia
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A - ask for help
L - lift legs (mcRoberts) A - Anterior shoulder disimpaction (supra pubic pressure and rubins) R - Rotation (rubins and wood's screw) M - manual removal of posterior arm E - episiotomy R - roll over to all fours (gaskin) |
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Management of shoulder dystocia
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inform woman and 2nd RM
inform woman she will need to assist with change of position and pushing when instructed call for help perform manoeuvres |
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how long before irreversible hypoxic injury to infants happen?
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6-8 minutes
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