Maternal Factors and Labor Interventions Predicting Shoulder Dystocia

Authors

  • Hadizadeh-Talasaz, Fatemeh Assistant Professor, Department of Midwifery, Social Development and Health Promotion Research Center, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
  • Nezami, Hosein PHD Student in Biostatistics, Department of Biostatistics and Epidemiology, Faculty of Health, Gonabad University of Medical Sciences, Gonabad, Iran
  • Rahmani Bilandi, Roghayeh Assistant Professor, Department of Midwifery, Social Development and Health Promotion Research Center, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
Abstract:

 Background and purpose: Shoulder dystocia is an obstetrics emergency which could be prevented by identifying its predictors and taking effective measures. The aim of this study was to determine the relationship between maternal factors and interventions for shoulder dystocia. Materials and methods: In this descriptive correlational study, we studied 6520 delivery files in a hospital in Sabzevar, Iran 2017-2018. All vaginal deliveries at 37-42 weeks with cephalic presentation were investigated and data of deliveries with shoulder dystocia (n=212) and without this condition (n=6308) were extracted using a researcher-made checklist. Mann-Whitney, Chi-square and logistic regression were applied for data analysis. Results: Findings showed significant differences between the two groups in mean age (P<0.001), body mass index (P<0.001), maternal weight (P=0.002), spontaneous labor (P<0.001), oxytocin augmentation (P=0.001), and vacuum extraction (P<0.001). In multiple logistic regression analysis, the only independent risk factor for shoulder dystocia was vacuum extraction (OR= 2.52, 95% CI: 1.596-3.978, P<0.001). Conclusion: According to this study, shoulder dystocia can be predicted in vacuum-assisted vaginal deliveries which could be prevented by reducing this procedure and using alternative methods such as Caesarean section.

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Journal title

volume 30  issue 190

pages  67- 75

publication date 2020-11

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