Document Detail

Antepartum risks of shoulder dystocia and brachial plexus injury for infants weighing 4,200 g or more.
MedLine Citation:
PMID:  9517796     Owner:  NLM     Status:  MEDLINE    
A cohort of 236 vaginally delivered neonates weighing > or = 4,200 g was evaluated. Shoulder dystocia was encountered in 27 deliveries (11.4%) and brachial plexus injury was diagnosed in 3 infants (1.3%). The 'traditional' antepartum risk factors could not be associated with shoulder dystocia. In this cohort, primiparity was significantly more frequent among the dystocia cases (OR = 8.58, 99% CI = 1.35-54.35, p = 0.021). Shoulder dystocia could not be attributed to a particular difference between the current and the previous heaviest birth weight. A policy of cesarean section for all infants weighing > or = 4,200 g would result in at least 5- to 6-fold increase in cesarean rate in this group of patients. Our data reconfirm that shoulder dystocia and brachial plexus injury are unpredictable, even in macrosomic infants. It is a matter of policy whether to accept the expected 1:9 and 1:79 respective risks associated with vaginal births.
I Blickstein; A Ben-Arie; Z J Hagay
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gynecologic and obstetric investigation     Volume:  45     ISSN:  0378-7346     ISO Abbreviation:  Gynecol. Obstet. Invest.     Publication Date:  1998  
Date Detail:
Created Date:  1998-04-23     Completed Date:  1998-04-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7900587     Medline TA:  Gynecol Obstet Invest     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  77-80     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel.
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MeSH Terms
Birth Weight*
Brachial Plexus / injuries*
Cesarean Section
Dystocia / etiology*
Fetal Macrosomia / complications*
Maternal Age
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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