Practice Bulletin No 178: Shoulder Dystocia

Shoulder dystocia is an unpredictable and unpreventable obstetric emergency that places the pregnant woman and fetus at risk of injury. Studies have shown that prepregnancy, antepartum, and intrapartum risk factors have extremely poor predictive value for shoulder dystocia. Several techniques to facilitate delivery exist, and there is evidence that a systematic approach and simulation training can improve outcomes and documentation. The purpose of this document is to provide clinicians with evidence-based information regarding management of pregnancies and deliveries at risk of or complicated by shoulder dystocia.