Risk Factors in Prediction of Shoulder Distocia

Purpose: The aim of this study was to evaluate the maternal, obstetric, and fetal risk factors, shoulder dystocia maneuvers, and perinatal outcomes of shoulder dystocia cases. Methods In this descriptive retrospective cross-sectional study, 66 documented shoulder dystocia (incidence 0.18%) groups from 36390 singleton vaginal deliveries between 2017 and 2022 in a gynecology&obstetrics hospital and 201 control groups selected from the computer-assisted randomization program on pregnancy, delivery, fetal and newborn outcomes data were evaluated and compared. Regression analysis were used to explain the relationship between the shoulder dystocia and risk factors. Results Mean age was significantly higher in the shoulder dystocia group (p < 0.05). In the stepwise binary logistic regression model analysis, hemoglobin level, abdominal circumference, femur length, estimated fetal weight, birth weight and second stage of labor were found to be significant risk factors for shoulder dystocia (p < 0.05). Measurement of abdominal circumference (sensitivity 81.8%, specificity 91.0%) and birth weight (sensitivity 62.4%, specificity 91.5%) were found to be the most significant risk factors for shoulder dystocia, while the other risk factors had low sensitivity (< 60.0%). Conclusion The low sensitivity of shoulder dystocia risk factors other than birth weight and abdominal circumference measurement indicates that the unpredictable feature of shoulder dystocia is preserved.