Book contents
- Best Practice in Labour and Delivery
- Reviews
- Best Practice in Labour and Delivery
- Copyright page
- Contents
- Contributors
- Preface to the Third Edition
- Acknowledgements
- Chapter 1 Pelvic and Fetal Cranial Anatomy and the Stages and Mechanism of Labour
- Chapter 2 The First Stage of Labour
- Chapter 3 Analgesia and Anaesthesia in Labour and Delivery
- Chapter 4 Intrapartum Fetal Monitoring
- Chapter 5 Uterine Contractions
- Chapter 6 Identification and Management of Presumed Intrapartum Fetal Distress
- Chapter 7 Prolonged Second Stage of Labour Including Difficult Decision-Making on Assisted Vaginal Birth and Caesarean Birth
- Chapter 8 Instrumental Vaginal Deliveries
- Chapter 9 Vaginal Breech Deliveries and External Cephalic Version
- Chapter 10 The Evidence-Based Caesarean Delivery Technique
- Chapter 11 Shoulder Dystocia
- Chapter 12 Umbilical Cord Prolapse
- Chapter 13 Twin Delivery
- Chapter 14 Antepartum Haemorrhage
- Chapter 15 Management of the Third Stage of Labour
- Chapter 16 Postpartum Haemorrhage
- Chapter 17 Management of Placenta Accreta Spectrum
- Chapter 18 Acute Illness and Maternal Collapse
- Chapter 19 Episiotomy and Obstetric Perineal Trauma
- Chapter 20 Induction of Labour
- Chapter 21 Preterm Pre-labour Rupture of Membranes
- Chapter 22 Preterm Birth
- Chapter 23 Labour in Women with Medical Disorders
- Chapter 24 Management of Women with Previous Caesarean Section
- Chapter 25 Hypertensive Disorders in Labour and Delivery
- Chapter 26 Rupture of the Uterus
- Chapter 27 Neonatal Resuscitation and the Management of Immediate Neonatal Problems
- Chapter 28 The Immediate Puerperium
- Chapter 29 Triage and Prioritisation on Labour Wards
- Chapter 30 Maternity Training in the Twenty-First Century
- Chapter 31 Risk Management in Intrapartum Care
- Chapter 32 Cerebral Palsy Arising from Events in Labour
- Chapter 33 Non-technical Skills to Improve Obstetric Practice
- Index
- References
Chapter 11 - Shoulder Dystocia
Published online by Cambridge University Press: 16 October 2025
Edited by
Book contents
- Best Practice in Labour and Delivery
- Reviews
- Best Practice in Labour and Delivery
- Copyright page
- Contents
- Contributors
- Preface to the Third Edition
- Acknowledgements
- Chapter 1 Pelvic and Fetal Cranial Anatomy and the Stages and Mechanism of Labour
- Chapter 2 The First Stage of Labour
- Chapter 3 Analgesia and Anaesthesia in Labour and Delivery
- Chapter 4 Intrapartum Fetal Monitoring
- Chapter 5 Uterine Contractions
- Chapter 6 Identification and Management of Presumed Intrapartum Fetal Distress
- Chapter 7 Prolonged Second Stage of Labour Including Difficult Decision-Making on Assisted Vaginal Birth and Caesarean Birth
- Chapter 8 Instrumental Vaginal Deliveries
- Chapter 9 Vaginal Breech Deliveries and External Cephalic Version
- Chapter 10 The Evidence-Based Caesarean Delivery Technique
- Chapter 11 Shoulder Dystocia
- Chapter 12 Umbilical Cord Prolapse
- Chapter 13 Twin Delivery
- Chapter 14 Antepartum Haemorrhage
- Chapter 15 Management of the Third Stage of Labour
- Chapter 16 Postpartum Haemorrhage
- Chapter 17 Management of Placenta Accreta Spectrum
- Chapter 18 Acute Illness and Maternal Collapse
- Chapter 19 Episiotomy and Obstetric Perineal Trauma
- Chapter 20 Induction of Labour
- Chapter 21 Preterm Pre-labour Rupture of Membranes
- Chapter 22 Preterm Birth
- Chapter 23 Labour in Women with Medical Disorders
- Chapter 24 Management of Women with Previous Caesarean Section
- Chapter 25 Hypertensive Disorders in Labour and Delivery
- Chapter 26 Rupture of the Uterus
- Chapter 27 Neonatal Resuscitation and the Management of Immediate Neonatal Problems
- Chapter 28 The Immediate Puerperium
- Chapter 29 Triage and Prioritisation on Labour Wards
- Chapter 30 Maternity Training in the Twenty-First Century
- Chapter 31 Risk Management in Intrapartum Care
- Chapter 32 Cerebral Palsy Arising from Events in Labour
- Chapter 33 Non-technical Skills to Improve Obstetric Practice
- Index
- References
Summary
Shoulder dystocia is defined as a vaginal cephalic delivery that requires additional obstetric manoeuvres to deliver the fetus after the head has been delivered and gentle downward traction has failed. Shoulder dystocia occurs when the anterior fetal shoulder, or less commonly the posterior shoulder, impacts on the maternal symphysis or the sacral promontory, respectively, preventing the delivery of the fetal body after the head has been delivered. The average gynaecoid pelvis at the inlet is 12cm in the anteroposterior diameter and 13cm in the transverse dimeter. The biacromial diameter of an average sized fetus is about 12-15cm. The shoulders usually traverse the pelvic inlet in the larger transverse diameter, though the biacrominal diameter is often larger the transverse diameter, there is usually no obstruction because the shoulders are compressible. Shoulder dystocia usually occurs when the fetal shoulders do not rotate to the wider oblique pelvic diameter. The incidence of shoulder dystocia in the largest case series ranges between 0.2% and 0.7%.
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- Best Practice in Labour and Delivery , pp. 137 - 148Publisher: Cambridge University PressPrint publication year: 2025
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