Risk of shoulder dystocia in second delivery: does a history of shoulder dystocia matter?

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• 作者：Eva A. Overl ; Anny Spydslaug ; Christopher S. Nielsen ; Anne Eskild
• 关键词：birthweight ; population study ; recurrence risk ; risk factors ; shoulder dystocia
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2009
• 出版时间：May 2009
• 年：2009
• 卷：200
• 期：5
• 页码：506.e1-506.e6
• 全文大小：232 K

文摘

Objective

Our aim was to estimate the relative and absolute risk of shoulder dystocia in the second delivery according to history of shoulder dystocia and offspring birthweight.

Study Design

A retrospective cohort study including all women in Norway with 2 consecutive singleton vaginal deliveries with fetus in cephalic presentation, during the period 1967-2005 (n = 537,316).

Results

In the second delivery shoulder dystocia occurred in 0.8 % of all women. In women with a prior shoulder dystocia the recurrence risk was 7.3 % . Most cases of shoulder dystocia in second delivery were in women without such history (96.2 % ). Offspring birthweight was the most important risk factor for shoulder dystocia in second delivery: crude odds ratio, 292.9 (95 % confidence interval, 237.8-360.7) comparing birthweight > 5000 g with 3000-3499 g.

Conclusion

Prior shoulder dystocia increased the risk of shoulder dystocia in the second delivery. However, offspring birthweight was by far the most important risk factor.