Article ID Journal Published Year Pages File Type
3921514 European Journal of Obstetrics & Gynecology and Reproductive Biology 2008 8 Pages PDF
Abstract

ObjectiveTo examine birth weight related risks of fetal injury in connection with shoulder dystocia.Study designThe investigation was based on a retrospective analysis of 316 fetal neurological injuries associated with deliveries complicated by arrest of the shoulders that occurred across the United States.ResultsThe study revealed that the distribution of birthweights for the high risk shoulder dystocia population differs from the standard birthweight distribution. The relative difference per birthweight interval is used to adjust an assumed 1:1000 baseline risk of injury due to shoulder dystocia following vaginal deliveries. These adjusted risks show a need to consider new thresholds for elective cesarean delivery.ConclusionsCurrent North American and British guidelines, that set 5000 g as minimum estimated fetal weight limit for elective cesarean section in non-diabetic and 4500 g for diabetic gravidas, may expose some macrosomic fetuses to a high risk of permanent neurological damage. The authors present the opinion that the mother, having been informed of the risks of vaginal versus abdominal delivery, should be allowed to play an active role in the critical management decisions.

Related Topics
Health Sciences Medicine and Dentistry Obstetrics, Gynecology and Women's Health
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