Shoulder dystocia in a Jamaican cohort.

Autor: Christie LR; Department of Obstetrics and Gynecology, University Hospital of the West Indies, Kingston, Jamaica. loxleychristie@hotmail.com, Harriott JA, Mitchell SY, Fletcher HM, Bambury IG
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2009 Jan; Vol. 104 (1), pp. 25-7. Date of Electronic Publication: 2008 Oct 25.
DOI: 10.1016/j.ijgo.2008.08.025
Abstrakt: Objective: To assess the risk factors for shoulder dystocia in Jamaica.
Methods: A retrospective cohort analysis of all cases of shoulder dystocia, and birth weight-matched controls identified from January 1, 2000 to December 31, 2004. Multiple factors were analyzed individually and in combination to identify risk factors.
Results: The incidence of shoulder dystocia was 0.83%. Nulliparity, a first stage of labor greater than 7 hours, a second stage lasting more than 1 hour, and use of oxytocin augmentation were found to be statistically significant factors with unadjusted odds ratios (95% confidence interval) of 1.78 (0.86-3.34), 1.89 (0.91-3.94), 2.78 (0.24-31.47), and 1.56 (0.77-3.15), respectively. The incidence of shoulder dystocia decreased as parity increased when adjusted for age.
Conclusion: Individual risk factors for shoulder dystocia remain obscure. The nulliparous pelvis, when controlled for neonatal weight, was associated with a statistically increased risk of shoulder dystocia; this risk decreased with increasing parity.
Databáze: MEDLINE
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