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Potential complications of shoulder dystocia
Even when successful, which is the case in the majority of cases, the manoeuvre applied to deliver the baby in shoulder dystocia, could result in one or more of the complications listed below. Some of the complications are not a direct result of the shoulder dystocia or the delivery manoeuvre but are an indirect consequence of the original predisposing factor.
The potential complications include:
- Postpartum hemorrhage
- Vaginal and perineal tear (3rd or 4th degree tear)
- Fistula involving the rectum (rectovaginal fistula)
- Uterine rupture (very rare)
- Injury to the symphysis pubis joint with separation of the bones.
For the baby, injuries that are sometimes sustained include:
- Injury to a group of nerves in the arm known as brachial plexus. The most common of those injuries results in what is known as Erb’s palsy. Most of these (90%) recover fully within 6 to 12 months. Up to 1 in 10 babies end up with a permanent neurological injury.
- Fracture of the collarbone and/or the humerus (bone in the upper arm). Collarbone fracture is sometimes applied deliberately to facilitate delivery in desperate situations.
- Fetal hypoxia when delivery is markedly delayed. This could cause permanent brain damage with cerebral palsy resulting.
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