Document Detail

Trends in the rate of shoulder dystocia over two decades.
MedLine Citation:
PMID:  16390789     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe the trend in the rate of shoulder dystocia over twenty-four years and identify the risk factors related to the occurrence of dystocia. METHODS: Data was obtained from Maryland State regarding all vaginal deliveries that occurred during six different time periods at five-year intervals since 1979. Trends in the rate of shoulder dystocia, episiotomy, forceps and vacuum delivery were examined. RESULTS: There were a total of 277 974 vaginal deliveries. The overall rate of shoulder dystocia was 1.29% (n = 3590). Induction of labor (adjusted OR 1.2, 1.1-1.3), presence of diabetes (gestational (OR 1.9, 1.7-2.3) or pre-gestational (OR 3.8, 2.7-5.4)), fetal macrosomia (OR 5.1, 4.1-6.3) use of episiotomy (OR 1.6, 1.5-1.8), forceps (OR 1.3, 1.0-1.8) or vacuum (OR 2.3, 2.0-3.9) at delivery were associated with a higher rate of shoulder dystocia. TREND: There was an increase in the rate of shoulder dystocia from 0.2% in 1979 to 2.11% in 2003. In addition there was a drop in the overall episiotomy rate from 73.67% to 23.94% and increase in the use of vacuum from 0.1% to 8.36%. CONCLUSION: The rate of shoulder dystocia has increased by 10 fold during the study period. The use of episiotomy either at spontaneous delivery or instrumental delivery does not appear to decrease the occurrence of shoulder dystocia.
Vani Dandolu; Lakesha Lawrence; John P Gaughan; Chad Grotegut; Ozgur H Harmanli; David Jaspan; Enrique Hernandez
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  18     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2006-01-04     Completed Date:  2006-05-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  305-10     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Temple University Hospital, Philadelphia, PA 19140, USA.
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MeSH Terms
Birth Injuries / epidemiology*
Brachial Plexus Neuropathies / epidemiology*
Databases as Topic
Diabetes Mellitus / epidemiology
Dystocia / epidemiology*
Episiotomy / adverse effects,  statistics & numerical data,  trends
Fetal Macrosomia / epidemiology
Labor, Induced / adverse effects,  statistics & numerical data
Logistic Models
Maryland / epidemiology
Obstetrical Forceps / adverse effects,  utilization
Risk Factors
Vacuum Extraction, Obstetrical / adverse effects,  trends,  utilization
Comment In:
J Matern Fetal Neonatal Med. 2006 May;19(5):315; author reply 315-6   [PMID:  16753774 ]

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

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