SHOULDER DYSTOCIA : OBSTETRICIAN'S NIGHTMARE

Shoulder dystocia is an uncommon complication of delivery. 12 cases of shoulder dystocia are presented. The study suggests that prediction of shoulder dystocia on the basis of clinical profile is difficult A high index of suspicion is to be maintained in the presence of certain risk factors such as multigravida with large baby having prolonged 1^st (decelarative phase) and 2^nd stage of labour necessitating instrumental delivery. High neonatal morbidity (brachial palsy 44% and low Apgar score 44%) was found to be associated with shoulder dystocia. Among the manoeuvres used for the delivery of impacted shoulder, no neonatal injuries were associated with successful McRoberts manoeuvre. However, the success rate of the procedure was only 50%. Fundal pressure in absence of other manoeuvres resulted in 100% complication rate, hence should be condemned.KEY WORDS: Brachial palsy, McRoberts manoeuvre, Shoulder dystocia