Shoulder dystocia: predictors and outcome. A five-year review

Am J Obstet Gynecol. 1987 Feb;156(2):334-6. doi: 10.1016/0002-9378(87)90278-x.


Shoulder dystocia is an uncommon complication of delivery with a high morbidity rate. Ninety-one cases were coded for shoulder dystocia at the Toronto General Hospital from 1980 through 1985. True shoulder dystocia was found in 24 cases, an incidence of 0.23%. There was no significant difference in average weight and percentage of macrosomia between cases of true shoulder dystocia and those merely coded as such. True shoulder dystocia was associated with a neonatal morbidity rate of 42%, consisting of a respiratory arrest and neurological and orthopedic damage. Fundal pressure, in the absence of other maneuvers, resulted in a 77% complication rate and was strongly associated with orthopedic and neurologic damage. Delivery of the posterior shoulder and the corkscrew maneuver were associated with good fetal outcome.

MeSH terms

  • Delivery, Obstetric / instrumentation
  • Delivery, Obstetric / methods
  • Dystocia / etiology*
  • Female
  • Fetal Macrosomia / complications
  • Humans
  • Labor Stage, Second
  • Pregnancy
  • Shoulder*