Document Detail


Can shoulder dystocia be reliably predicted?
MedLine Citation:
PMID:  22428758     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: To evaluate factors reported to increase the risk of shoulder dystocia, and to evaluate their predictive value at a population level. METHODS: The South Australian Pregnancy Outcome Unit's population database from 2005 to 2010 was accessed to determine the occurrence of shoulder dystocia in addition to reported risk factors, including age, parity, self-reported ethnicity, presence of diabetes and infant birth weight. Odds ratios (and 95% confidence interval) of shoulder dystocia was calculated for each risk factor, which were then incorporated into a logistic regression model. Test characteristics for each variable in predicting shoulder dystocia were calculated. RESULTS: As a proportion of all births, the reported rate of shoulder dystocia increased significantly from 0.95% in 2005 to 1.38% in 2010 (P = 0.0002). Using a logistic regression model, induction of labour and infant birth weight greater than both 4000 and 4500 g were identified as significant independent predictors of shoulder dystocia. The value of risk factors alone and when incorporated into the logistic regression model was poorly predictive of the occurrence of shoulder dystocia. CONCLUSIONS: While there are a number of factors associated with an increased risk of shoulder dystocia, none are of sufficient sensitivity or positive predictive value to allow their use clinically to reliably and accurately identify the occurrence of shoulder dystocia.
Authors:
Jodie M Dodd; Britt Catcheside; Wendy Scheil
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-19
Journal Detail:
Title:  The Australian & New Zealand journal of obstetrics & gynaecology     Volume:  -     ISSN:  1479-828X     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0001027     Medline TA:  Aust N Z J Obstet Gynaecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Affiliation:
Discipline of Obstetrics and Gynaecology, Robinson Institute, The University of Adelaide, North Adelaide.
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