Clinical Review

Delivery dilemmas: shoulder dystocia

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References

Postdelivery procedures

Once the newborn has been delivered, it is important that a pediatrician fully examine the infant in the delivery room, even if no neonatal injury is apparent. In cases of recognized injury, appropriate diagnosis, followup, and treatment referral is crucial for both parents and neonate.

Medical records should include a clear and concise discussion of the delivery, personnel present , measures taken, and immediate neonatal result. Always dictate your note to ensure its legibility.

Also be sure that the medical records carefully describe the labor and delivery process. Notation should include a clear and concise discussion of the delivery, personnel present, measures taken, and immediate neonatal result. Always dictate your note to ensure its legibility—never rely on preformatted delivery notes. These documents are invaluable assets in the aftermath of a difficult delivery.

Final thoughts

Difficulty in delivering the shoulders is a relatively frequent obstetrical issue that can present a significant challenge to delivery staff. A thorough understanding of the labor process and techniques employed when this scenario arises can help us best protect both fetus and mother. Ongoing efforts to recognize, avoid, and ameliorate significant injury are a daily challenge to providers of intrapartum obstetric care, especially in the face of challenging deliveries.

The authors report no financial relationship with any companies whose products are mentioned in this article.

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