Why are so many cases of shoulder dystocia mismanaged?

December 1, 2008

Clinicians are still making common mistakes when trying to resolve a shoulder dystocia.

Clinicians are still making common mistakes when trying to resolve a shoulder dystocia. At least that's what this review of videotaped simulations suggests.

When researchers video recorded 450 simulated shoulder dystocia scenarios managed by 95 midwives and 45 physicians from six hospitals in the United Kingdom over the course of 1 year, they found that before receiving specialized training more than half (57%) of the practitioners were unable to deliver the baby, almost two-thirds (63%) failed to call for pediatric support, and 1 in 27 (4%) used fundal (rather than suprapubic) pressure, which is potentially harmful.

The videos showed that certain elements occurred again and again:

Crofts JF, Fox F, Ellis D, et al. Observations from 450 shoulder dystocia simulations: lessons for skills training. Obstet Gynecol. 2008;112:906-912.