The proposal of the novel fetal shoulder dystocia graduation: a clinical-based opinion
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Dubravko Habek
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Mislav Mikuš
Abstract
Background
Shoulder dystocia is a peracute mechanical dystocia and a prepartum, usually unpredictable, life-threatening entity with significant forensic implications due to significantly poor perinatal outcome, especially permanent disability or perinatal death.
Content
To better objectify the graduation and to include other important clinical parameters, we believe it is appropriate to present a proposal for a complete perinatal weighted graduation of shoulder dystocia, based on several years of numerous other and our own clinical and forensic studies and thematic biobibliography. Obstetric maneuvers, neonatal outcome, and maternal outcome are three components, which are evaluated according to the severity of 0–4 proposed components. Thus, the gradation is ultimately in four degrees according to the total score: I. degreee, score 0–3: slightly shoulder dystocia with simple obstetric interventions, but without birth injuries; II. degree, score 4–7: mild shoulder dystocia resolved by external, secondary interventions and minor injuries; III. degree, score 8–10: severe shoulder dystocia with severe peripartum injuries; IV. degree, score 11–12: extremely difficult, severe shoulder dystocia with ultima ratio interventions applied and resulting extremely severe injuries with chronic disability, including perinatal death.
Summary
As a clinically evaluated graduation, it certainly has an applicable long-term anamnestic and prognostic component for subsequent pregnancies and access to subsequent births, as it includes all relevant components of clinical forensic objectification.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: Not applicable.
References
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© 2023 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Obituary
- A tribute to Professor Moshe Mazor, M.D.
- Mini Review
- Systematic review of the long-term effects of postnatal corticosteroids
- Opinion Paper
- The proposal of the novel fetal shoulder dystocia graduation: a clinical-based opinion
- Corner of Academy
- Prenatal diagnosis of bilobate placenta: incidence, risk factors and impact on pregnancy outcomes
- Original Articles – Obstetrics
- High mobility group box 1 in women with unexplained recurrent pregnancy loss
- Velamentous cord insertion in monochorionic twin pregnancies: a step forward in screening for twin to twin transfusion syndrome and birthweight discordance?
- Advanced maternal age (AMA) and 75 g oGTT glucose levels are pedictors for insulin therapy in women with gestational diabetes (GDM)
- Perinatal, obstetric and parental risk factors for asthma in the offspring throughout childhood: a longitudinal cohort study
- Increased risk of severe COVID-19 in pregnancy in a multicenter propensity score-matched study
- Comparative clinical and placental pathologic characteristics in pregnancies with and without SARS-CoV-2 infection
- An analysis of factors affecting survival in prenatally diagnosed omphalocele
- The impact of abnormal maternal body mass index during pregnancy on perinatal outcomes: a registry-based study from Qatar
- Original Articles – Fetus
- Embryonic and fetal tiny pericardial fluid collections at less than 12 weeks of gestation
- Modeling fetal cortical development by quantile regression for gestational age and head circumference: a prospective cross sectional study
- The effect of 50 GR oral glucose tolerance test on fetal celiac artery and superior mesenteric artery Doppler parameters in healthy pregnancies
- Original Articles – Neonates
- Carboxyhaemoglobin levels in infants with hypoxic ischaemic encephalopathy
- Exploring professionals’ views regarding prenatal counselling in congenital diaphragmatic hernia
- Letter to the Editor
- Cutting of the strangulated double nuchal umbilical cord in a release of the severe shoulder dystocia: forensically justified or controversial procedure
- Retraction
- Retraction of: Pre-operative tranexemic acid vs. etamsylate in reducing blood loss during elective cesarean section: randomized controlled trial
- Retraction of: Lidocaine vs. tramadol vs. placebo wound infiltration for post-cesarean section pain relief: a randomized controlled trial
Articles in the same Issue
- Frontmatter
- Obituary
- A tribute to Professor Moshe Mazor, M.D.
- Mini Review
- Systematic review of the long-term effects of postnatal corticosteroids
- Opinion Paper
- The proposal of the novel fetal shoulder dystocia graduation: a clinical-based opinion
- Corner of Academy
- Prenatal diagnosis of bilobate placenta: incidence, risk factors and impact on pregnancy outcomes
- Original Articles – Obstetrics
- High mobility group box 1 in women with unexplained recurrent pregnancy loss
- Velamentous cord insertion in monochorionic twin pregnancies: a step forward in screening for twin to twin transfusion syndrome and birthweight discordance?
- Advanced maternal age (AMA) and 75 g oGTT glucose levels are pedictors for insulin therapy in women with gestational diabetes (GDM)
- Perinatal, obstetric and parental risk factors for asthma in the offspring throughout childhood: a longitudinal cohort study
- Increased risk of severe COVID-19 in pregnancy in a multicenter propensity score-matched study
- Comparative clinical and placental pathologic characteristics in pregnancies with and without SARS-CoV-2 infection
- An analysis of factors affecting survival in prenatally diagnosed omphalocele
- The impact of abnormal maternal body mass index during pregnancy on perinatal outcomes: a registry-based study from Qatar
- Original Articles – Fetus
- Embryonic and fetal tiny pericardial fluid collections at less than 12 weeks of gestation
- Modeling fetal cortical development by quantile regression for gestational age and head circumference: a prospective cross sectional study
- The effect of 50 GR oral glucose tolerance test on fetal celiac artery and superior mesenteric artery Doppler parameters in healthy pregnancies
- Original Articles – Neonates
- Carboxyhaemoglobin levels in infants with hypoxic ischaemic encephalopathy
- Exploring professionals’ views regarding prenatal counselling in congenital diaphragmatic hernia
- Letter to the Editor
- Cutting of the strangulated double nuchal umbilical cord in a release of the severe shoulder dystocia: forensically justified or controversial procedure
- Retraction
- Retraction of: Pre-operative tranexemic acid vs. etamsylate in reducing blood loss during elective cesarean section: randomized controlled trial
- Retraction of: Lidocaine vs. tramadol vs. placebo wound infiltration for post-cesarean section pain relief: a randomized controlled trial
