Shoulder Dystocia Injury: Baby’s Shoulder Injury in Details

Shoulder dystocia injury can be a serious injury for a baby. Somehow, delivering a baby does not mean no bad probability happens to the baby or the mother at all. There are many excuses why this injury reaches the newborn. What are those? Let’s find out through the discussion of this article! 

What Shoulder Dystocia Injury Is About? 

Shoulder dystocia injury is a medical complication that can occur during childbirth. It happens after the baby’s head has passed through the vaginal opening. Just then, one or both of the baby’s shoulders get stuck behind the mother’s pelvic bone. 

Somehow, it can be a challenging situation for healthcare providers during delivery. Furthermore, shoulder dystocia can lead to various complications, and it is deemed an obstetric emergency. One of the significant concerns associated with shoulder dystocia is the potential for birth injuries, both for the baby and the mother. 

Anyway, some of the potential complications and injuries related to shoulder dystocia are below.

1. Brachial Plexus Injury

Brachial Plexus is one of the most common injuries associated with shoulder dystocia injury. The brachial plexus is a network of nerves controlling the muscles of the arm and hand. 

During a difficult delivery, excessive force or stretching of the brachial plexus can cause injury. This sort of issue leads to conditions like Erb’s palsy or Klumpke’s palsy.

2. Fractures

A newborn may experience fractures. It is typically to the clavicle or collarbone. In addition, fractures may happen due to the pressure and forces applied during attempts to resolve the shoulder dystocia.

3. Hypoxia

Prolonged shoulder dystocia can lead to a decrease in oxygen supply to the baby (hypoxia). Likewise, Hypoxia may result in various complications, including brain damage.

4. Maternal Injuries

Besides the baby, the mother may also experience injuries as well. Injuries can happen to mothers during attempts to resolve shoulder dystocia injury. Those side injuries are such as tears or lacerations.

What Are The Risk Factors of Shoulder Dystocia Injury? 

Based on the International Health Journal from the National Library of Medicine, Here are some shoulder dystocia injury risk factors you should check to avoid such an issue.

1. Newborn Weight

About half of all incidences of shoulder dystocia arise in the 10% or so of mothers who have a baby reaching 4 kg or more. This case seems to be the reason that the mother would give birth to fewer large babies. Somehow, it also results in less shoulder dystocia. 

In addition, in nondiabetic women, the mother’s weight before pregnancy and what amount of weight she accumulates throughout pregnancy are the key determinants of a baby’s birth weight. In some cases, overweight women would achieve their optimal weight before conception. 

However, decreasing weight is difficult and unlikely to be commonly achieved. In terms of weight gain during pregnancy, it was standard procedure decades ago for the obstetrician to chastise the pregnant lady if she gained too much weight. Yet, obstetricians nowadays are reluctant to chastise their patients.

2. Maternal Obesity

Maternal diabetes is another definite risk factor for having a baby weighing over 4 kg. However, checking maternal obesity can be one of the risk factors for shoulder dystocia injury as well. Women diagnosed with diabetes have a 20% probability of having a baby weighing more than 4 kg. 

The primary rationale for treating diabetic women with hypoglycemic medications and/or insulin is to lower the risk of third-trimester stillbirth, however, therapy also reduces the risk of macrosomia. 

When a diabetic woman has a fetus with approaching macrosomia (abdominal circumference measurement of around 360 or so), delivery should be seriously evaluated. Nevertheless, it is not so much to lower the risk of shoulder dystocia as it is to lessen the risk of unexplained stillbirth.

Although some pregnant women do not have hyperglycemia which provides a high risk of stillbirth, glucose-lowering medication will minimize the likelihood of macrosomia, and presumably shoulder dystocia.

The Prevention of Shoulder Dystocia Injury

Based on the data from webMD.com, shoulder dystocia injury should be unavoidable. The medical staff, on the other hand, may detect shoulder dystocia at an early stage and treat it before it worsens. 

If the patient had a prior pregnancy that was challenged by shoulder dystocia, the doctor may suggest that they should have a c-section. This assures that neither the mother nor the baby suffer any harmful health consequences. 

Yet, the data from emedicine says that shoulder dystocia is nearly impossible to predict or prevent in an individual patient. Yet, it also says that the incidence of shoulder dystocia in a population can be reduced by identifying and caring for mild gestational diabetes mellitus.

Anyways, its reduction refers to 2 or more abnormal results after a 3-hour 100-g oral glucose tolerance test, but with a glucose fasting level of 95 mg/dL. In addition, the patient must do self-monitoring of blood glucose, food, and insulin treatment, when needed. 

However, the treatment led to a 60% reduction in large-for-gestational-age (LGA) newborns, cesarean births, and shoulder dystocia.  It is debatable to raise the criteria for diabetic diagnosis. So, raising the diabetic rate from 5% to 18% of pregnancies is an ultimately successful treatment approach.

The Initial Response

Physicians should notify the fetal head’s arrival so that aid may start a timer. If the fetus does not deliver with normal traction or if there is retraction of the fetal head against the perineum (turtle sign), the physician should declare that there is shoulder dystocia injury. 

Just then, the delivery team should request extra team members to help. When the delivery team performed certain activities during shoulder dystocia births, a longitudinal evaluation of a shoulder dystocia simulation program demonstrated a substantial reduction in infant brachial plexus injuries after discharge (7.6% to 1.3%). 

These included a clear declaration of shoulder dystocia. For instance, requesting extra assistance from experienced staff, and having an assistant proclaim the time from fetal head delivery every 30 seconds.

Recognize and Learn Shoulder Dystocia Right Now!

Considering shoulder dystocia injury is a serious condition of a newborn after reading the article above, we should learn more. By recognizing this injury, we might be able to avoid the worst possibility of it happening. Therefore, Let’s take a chance to learn about it and do the routine pregnancy check-up!