Stratification of outcome of shoulder dystocia according to maneuver used for delivery, retrospective cohort and meta-analysis.

Autor: Elbarbary N; Obstetrics and Gynaecology Department, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK., Atre R; Obstetrics and Gynaecology Department, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK., Kurian D; Obstetrics and Gynaecology Department, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK., Viswanatha R; Obstetrics and Gynaecology Department, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK., Ghai V; Obstetrics and Gynaecology Department, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK., Ganapathy R; Obstetrics and Gynaecology Department, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2024 Dec; Vol. 167 (3), pp. 1160-1167. Date of Electronic Publication: 2024 Jul 14.
DOI: 10.1002/ijgo.15783
Abstrakt: Background: Shoulder dystocia is an unpredictable obstetric condition with potential long-term neonatal complications. The risk of neonatal injury might be related to the condition itself as well as to the obstetrics maneuvers used for its release.
Objectives: To examine the available evidence to assess current management and possible improvement of outcomes.
Search Strategy: A comprehensive search of MEDLINE, EMBASE, EMCARE, and The Cochrane Library database was performed, all studies reporting on neonatal outcomes in cases of shoulder dystocia stratified by obstetric maneuvers used for delivery were included. Data abstraction was performed and checked by two independent reviewers.
Results: McRoberts maneuver was the least associated with risk of neonatal injury (odds ratio 0.6, 95% confidence interval 0.4-0.9), followed by delivery of posterior arm.
Conclusion: Delivery of posterior arm might be prioritized in cases of shoulder dystocia after failed McRoberts. Neonatal hypoxic injury correlates with the duration of dystocia rather than the maneuver used.
(© 2024 International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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