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August 20, 2025

Maternal and Neonatal Complications of Shoulder Dystocia With a Focus on Obstetric Maneuvers: A Case-control Study of 1103 Deliveries

Key Points

Shoulder dystocia significantly increases both maternal and neonatal complications, impacting their health outcomes.
The use of three or more obstetric maneuvers is associated with improved maternal and neonatal results when addressing shoulder dystocia.
Assessment of 537 shoulder dystocia cases revealed effective use of maneuvers like McRoberts and suprapubic pressure across 181,352 deliveries.
The findings suggest a need for standardized protocols to manage shoulder dystocia effectively during labor.

Abstract

( Acta Obstet Gynecol Scand . 2024;103(10):1965–1974. DOI: 10.1111/aogs.14780) Shoulder dystocia is a serious obstetric emergency that can lead to significant maternal and neonatal complications. This study aimed to evaluate the frequency, success, and impact of various obstetric maneuvers in managing shoulder dystocia, as well as their association with maternal and neonatal outcomes. The study included a large sample of 181,352 deliveries from the Hospital District of Helsinki and Uusimaa between 2006 and 2015. Data were extracted using ICD-10 codes for brachial plexus injury, shoulder dystocia, and clavicle fractures, identifying 537 cases of shoulder dystocia. These cases were examined for the application of specific obstetric maneuvers, including McRoberts maneuver, rotational maneuvers, suprapubic pressure, and posterior arm delivery. The effectiveness of 1 or 2 maneuvers was compared with that of at least 3 maneuvers. A control group of 566 parturients without the aforementioned complications was also analyzed.

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