Delivery dilemmas: shoulder dystocia
It’s obstetric challenges such as these that test our skills in the delivery room—and expose us to greatest medicolegal risk. Here, the authors detail predelivery warning signs and specific intrapartum maneuvers that can help obstetricians rise to the challenge of this difficult delivery.
Postdelivery procedures
Once the newborn has been delivered, it is important that a pediatrician fully examine the infant in the delivery room, even if no neonatal injury is apparent. In cases of recognized injury, appropriate diagnosis, followup, and treatment referral is crucial for both parents and neonate.
Medical records should include a clear and concise discussion of the delivery, personnel present , measures taken, and immediate neonatal result. Always dictate your note to ensure its legibility.
Also be sure that the medical records carefully describe the labor and delivery process. Notation should include a clear and concise discussion of the delivery, personnel present, measures taken, and immediate neonatal result. Always dictate your note to ensure its legibility—never rely on preformatted delivery notes. These documents are invaluable assets in the aftermath of a difficult delivery.
Final thoughts
Difficulty in delivering the shoulders is a relatively frequent obstetrical issue that can present a significant challenge to delivery staff. A thorough understanding of the labor process and techniques employed when this scenario arises can help us best protect both fetus and mother. Ongoing efforts to recognize, avoid, and ameliorate significant injury are a daily challenge to providers of intrapartum obstetric care, especially in the face of challenging deliveries.
The authors report no financial relationship with any companies whose products are mentioned in this article.
