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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 3/2016

01-09-2016 | Maternal-Fetal Medicine

Is fetal manipulation during shoulder dystocia management associated with severe maternal and neonatal morbidities?

Authors: Bertrand Gachon, David Desseauve, Xavier Fritel, Fabrice Pierre

Published in: Archives of Gynecology and Obstetrics | Issue 3/2016

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Abstract

Purpose

There is a lack of data regarding maternal morbidity and neonatal hypoxia associated with shoulder dystocia (SD), particularly with respect to whether SD is managed with our without fetal manipulation (FM). Our main objective was to compare severe maternal and neonatal morbidities associated with SD according to FM execution.

Methods

We conducted a retrospective study based on a medical record analysis that included all SD cases from 2007 to 2012. SD was considered when additional maneuvers were required to complete a delivery. Severe maternal morbidity was defined as the occurrence of an obstetric anal sphincter injury. Severe neonatal morbidity was defined as the occurrence of one of these complications: permanent brachial plexus palsy, arterial cord pH < 7.1, Apgar score < 7 at 5 min. We compared severe maternal and neonatal morbidities in the FM and the no-FM group.

Results

We report an SD incidence of 2.4 % (n = 227) with 93.8 % of patients treated without FM. We identified two cases of permanent brachial plexus palsy, fifteen cases of arterial cord pH < 7.1 and six cases with an Apgar score < 7 at 5 min; all of them were from the no-FM group. There were more cases of OASI in the FM group (odd ratio = 9.2 [1.32–50.71]). No statistical differences between these groups were observed with respect to severe neonatal morbidity.

Conclusions

Severe neonatal morbidity does not appear to be associated with FM during SD management, but severe maternal morbidity is associated with FM execution.
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Metadata
Title
Is fetal manipulation during shoulder dystocia management associated with severe maternal and neonatal morbidities?
Authors
Bertrand Gachon
David Desseauve
Xavier Fritel
Fabrice Pierre
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 3/2016
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-016-4013-1

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