Shoulder dystocia results in the following except: March 2007
**Core Concept**
Shoulder dystocia is a complication that can occur during vaginal deliveries, particularly in cases where the fetal head is large or the mother has diabetes. It occurs when the anterior shoulder of the fetus becomes impacted against the maternal pubic symphysis, preventing the delivery of the rest of the body. This can lead to significant complications for both the mother and the baby.
**Why the Correct Answer is Right**
Shoulder dystocia is characterized by a series of clinical signs, including:
* Failure to deliver the anterior shoulder after the delivery of the head
* The delivery of the posterior shoulder is delayed or obstructed
* The baby's body is not delivered within 30 seconds after the delivery of the head
* The mother may experience severe perineal trauma or uterine atony
The clinical diagnosis of shoulder dystocia is often made by the obstetrician or midwife based on these signs, which can be life-threatening if not promptly recognized and managed.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not a consequence of shoulder dystocia. While maternal injury can occur, it is not a direct consequence of shoulder dystocia.
* **Option B:** This option is incorrect because shoulder dystocia does not typically result in fetal death. However, it can lead to significant fetal morbidity, including brachial plexus injury, clavicular fracture, and hypoxic-ischemic encephalopathy.
* **Option C:** This option is incorrect because shoulder dystocia is not a normal variation in delivery. It is a complication that requires prompt recognition and management to prevent serious consequences.
**Clinical Pearl / High-Yield Fact**
The mnemonic "HELPERR" can be used to remember the steps in managing shoulder dystocia:
* H: Hyper-extend the mother's back
* E: Elevate the mother's legs
* L: Apply suprapubic pressure
* P: Push the baby's arm or shoulder
* E: Enlist assistance from other healthcare providers
* R: Remove the baby's arm or shoulder from the birth canal
* R: Rotate the baby's body to facilitate delivery
**Correct Answer: D.**