Shoulder Dystocia

Publication Date: May 1, 2017
Last Updated: March 14, 2022

Recommendations

Although there are a number of known risk factors, shoulder dystocia cannot be accurately predicted or prevented. Clinicians should be aware of the risk factors for shoulder dystocia in order to anticipate those deliveries at high risk and should be prepared to address this complication in all deliveries. ( B )
574

Elective cesarean delivery should be considered for women without diabetes who are carrying fetuses with suspected macrosomia with an estimated fetal weight of at least 5,000 g and for women with diabetes whose fetuses are estimated to weigh at least 4,500 g. (B)
574

When shoulder dystocia is suspected, the McRoberts maneuver should be attempted first because it is a simple, logical, and effective technique. (B)
574

Contemporaneous documentation of the management of shoulder dystocia is recommended to record significant facts, findings, and observations about the shoulder dystocia event and its sequelae. (B)
574

Simulation exercises and shoulder dystocia protocols are recommended to improve team communication and maneuver use because this may reduce the incidence of brachial plexus palsy associated with shoulder dystocia. (B)
574

In cases where the McRoberts maneuver and suprapubic pressure are unsuccessful, delivery of the posterior arm can be considered as the next maneuver to manage shoulder dystocia. (C)
574

Recommendation Grading

Overview

Title

Shoulder Dystocia

Authoring Organization

Publication Month/Year

May 1, 2017

Last Updated Month/Year

January 5, 2023

Document Type

Consensus

External Publication Status

Published

Country of Publication

US

Health Care Settings

Emergency care, Hospital

Intended Users

Physician, nurse midwife, nurse, nurse practitioner, physician assistant

Scope

Management

Diseases/Conditions (MeSH)

D004420 - Dystocia, D000080883 - Shoulder Dystocia

Keywords

dystocia, shoulder dystocia