Objective
We examined outcomes that were associated with a novel program to identify patients
who are at high risk for shoulder dystocia with brachial plexus injury.
Study Design
The program included a checklist of key risk factors and a multifactorial algorithm
to estimate risk of shoulder dystocia with brachial plexus injury. We examined rates
of cesarean delivery and shoulder dystocia in 8767 deliveries by clinicians who were
enrolled in the program and in 11,958 patients of clinicians with no access to the
program.
Results
Key risk factors were identified in 1071 of 8767 mothers (12.2%), of whom 40 of 8767
women (0.46%) had results in the high-risk category. The rate of primary cesarean
delivery rate was stable (21.2-20.8%; P = .57). Shoulder dystocia rates fell by 56.8% (1.74-0.75%; P = .002). The rates of shoulder dystocia and cesarean birth showed no changes in the
group with no access to the program.
Conclusion
With the introduction of this program, overall shoulder dystocia rates fell by more
than one-half with no increase in the primary cesarean delivery rate.
Key words
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Article Info
Publication History
Published online: June 04, 2012
Accepted:
May 26,
2012
Received in revised form:
May 21,
2012
Received:
March 5,
2012
Footnotes
Supported financially by PeriGen, Princeton, NJ.
M.V.D. has no conflict of interest. C.B., K.E.T., and E.F.H. are employed by PeriGen.
Reprints not available from the authors.
Cite this article as: Daly MV, Bender C, Townsend KE, et al. Outcomes associated with a structured prenatal counseling program for shoulder dystocia with brachial plexus injury. Am J Obstet Gynecol 2012;207:123.e1-5.
Identification
Copyright
© 2012 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
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- Shoulder dystocia outcomes associated with structured prenatal counselingAmerican Journal of Obstetrics & GynecologyVol. 208Issue 3
