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Shoulder Dystocia Preparedness

July 20, 2022
July 20, 2022

Preparing for low-incidence, high-risk obstetrical emergencies is difficult, but should be an important part of your organization’s strategy to improve maternal child health outcomes. Shoulder dystocia is one of rarest of obstetrical complications, occurring in somewhere between 1% and 3% of all pregnancies. However, when it does occur, healthcare providers have mere minutes in which to respond.

 

Shoulder Dystocia – What is it?

Shoulder Dystocia is an obstetrical emergency that occurs when one or both of a baby’s shoulders becomes stuck inside a laboring women’s pelvis. It is a low-incidence complication that can cause death or injury to both mother and baby. Further complicating matters is the fact that it is difficult to predict, which in turn, makes it hard to prevent. In most cases of shoulder dystocia, the baby is safely delivered and both mother and baby will recover fully from any problems associated with the birth, but this is not always the case.

While shoulder dystocia occurs infrequently, there are some risk factors that make it somewhat more likely. The March of Dimes identifies macrosomia (a baby weighing more than 8 pounds), pre-existing or gestational diabetes, and being pregnant with multiples as potential risk factors for shoulder dystocia. In addition to these risk factors, there are some aspects of labor and delivery that may make shoulder dystocia more likely. These factors include the use of oxytocin, the use of an epidural, a very short or a very long second stage of labor and having an assisted vaginal birth.

 

Shoulder Dystocia – The consequences

While a well-trained team of providers can usually safely deliver a baby when faced with shoulder dystocia, failure to do so can have serious consequences for both mother and baby. The baby may experience problems including arm and collarbone fractures, brachial plexus nerve damage and asphyxia. The mother may experience perineum tearing, post-partum hemorrhage and, in rare cases, uterine rupture.

A nursing staff that understands how to recognize the risks and signs of shoulder dystocia can mitigate these risks. So how should hospitals prepare their obstetrical teams to manage this type of emergency?

 

Shoulder Dystocia – Regular training for your nursing staff

It is an understatement to say that U.S. maternal child health statistics continue to disappoint, but there are solutions that can help build both competence and confidence amongst your obstetrical staff. HealthStream’s Quality OB Program can help your team with engaging content that can prepare them to respond to an obstetrical emergency – even those emergencies that happen extremely infrequently. Nothing is more important than a high-functioning team when there is an obstetrical emergency, and the Quality OB Program is data-driven education that will help your organization build a team that can respond appropriately to this and other kinds of obstetrical emergencies.

Your organization can use the Quality OB Program with confidence as HealthStream has partnered with the best organizations to provide high-quality, reliable content. The data-driven program targets six key competencies and uses virtual microsimulation and incremental, high-frequency learning to ensure safe, high-quality obstetrical care. In addition to the module on Shoulder Dystocia, the program also includes modules on Electronic Fetal Monitoring, Postpartum Hemorrhage, Hypertension in Pregnancy, Trial of Labor after Cesarean, and Effective Communication and Event Disclosure. Leaders can feel confident in the efficacy of the program with the use of pre- and post-assessments and tools that determine the variance between knowledge and the application of that knowledge.