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Follow the rules with shoulder dystocia: avoid fundal pressure.(Obstetrics)
ATLANTA -- "Never, never, never!" is Dr. Washington C. Hill's advice on when to apply fundal pressure for shoulder dystocia.
This can further impact the shoulder and is clearly associated with orthopedic and neurologic damage. It also is very hard to defend legally, Dr. Hill said at a conference on high-risk obstetrics sponsored by Symposia Medicus.
In most cases, gentle downward traction and McRoberts' maneuver, in which the mother's legs are flexed up and onto her abdomen, changing the position of her pelvis relative to her spine, will successfully disengage the shoulder.
"But despite our best efforts and the use of appropriate maneuvers injuries do occur," said Dr. Hill, chairman of the department of obstetrics and gynecology and director of maternal-fetal medicine at Sarasota (Fla.) Memorial Hospital.
Fortunately, most brachial plexus injuries improve within 18 months. And even if the injury is permanent, it does not necessarily mean malpractice, he said.
Central to defense against malpractice for shoulder dystocia-related injury is a ...
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- Magazine article from: OB GYN News Boschert, Sherry March 1, 2004 700+ words
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- Magazine article from: Family Practice News Boschert, Sherry July 1, 2004 700+ words
...baby with shoulder dystocia fall into...traction with fundal pressure, which increased...compared with no fundal pressure in a third...the law. "Fundal pressure absolutely...baby with shoulder dystocia has a bad...
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- Magazine article from: Trial Manley, Giles May 1, 2007 700+ words
...the presence of shoulder dystocia and showing how...stretched but not torn. Shoulder dystocia occurs either when...mother's abdomen; fundal pressure, performed high...to use it. When shoulder dystocia occurs, the patient...
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- Shoulder dystocia drills can improve response.
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- Legal Review & Commentary: Shoulder dystocia during delivery.
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- Magazine article from: OB GYN News Zoler, Mitchel L. April 15, 2003 700+ words
...Macrosomia is not the only route to shoulder dystocia. "The problem with shoulder dystocia is that not all cases involve babies...and the law. 'About 40%-50% of shoulder dystocia cases involve babies without macrosomia...
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- Press release article from: PR Newswire February 2, 2006 700+ words
...issue of injury sustained due to shoulder dystocia, a condition which occurs during...the mother's pelvis. Until now shoulder dystocia has been widely believed to be unpredictable...Research, demonstrate that the risk of shoulder dystocia with injury can be predicted thereby...
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- Magazine article from: OB GYN News Moon, Mary Ann December 15, 2004 700+ words
...weight is just as rare in cases of shoulder dystocia as it is in normal deliveries, so...used as a basis for litigation in shoulder dystocia cases, Shobha Mehta, M.D...cited by plaintiffs' attorneys in shoulder dystocia cases" with the implication that...
Source: HighBeam Research, Follow the rules with shoulder dystocia: avoid fundal...