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Incidence of shoulder dystocia and its relation to brachial plexus palsy: a 10 year retrospective review at King Abdulaziz University Hospital

Ayman A. Bukhari, Osama S. Bajouh, Dania M. Bresali, Alaa A. Roblah, Zahraa I. Alghafli, Dareen A. Khawjah, Bushra K. Alhawsa.

Abstract
Background: Objective of the study was to determine the incidence of shoulder dystocia (SD) in King Abdulaziz University Hospital (KAUH), with a focus on Brachial Plexus Palsy (BPP) and the accompanying risk factors.
Methods: We conducted a retrospective study of all vaginal deliveries between 2005 and 2014. Out of 29,199 vaginal deliveries, 236 cases where diagnosed with SD at KAUH in Jeddah, KSA. The following maternal and perinatal variables were reviewed by the patients' medical records: (booking status, maternal age, gestational age, maternal Body Mass Index (BMI), presence of diabetes, previous history of SD, instrumental delivery, Birth weight, Erb's and Klumpke's palsies).
Results: A total of 236 cases had SD with an incidence of (0.8%). Only 55 cases among all had BPP. The Erb's palsy was found in 54 cases (30.7%) while Klumpke's palsy was found only in one case (0.6%). There were 121 (68.8%) cases with no BPP and a remaining of 60 unknown BPP outcomes. From the total number of cases with SD, mothers with overweight and obesity were found in 93% of the cases.
Conclusions: Most of clinically diagnosed SD cases did not give the consequence of BPP. However, this complication in addition to other complications of SD mandates extra caution in cases with risk factors.

Key words: Brachial plexus palsy, Erb’s palsy, Shoulder dystocia


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