Shoulder Dystocia: Place in Midwifery Education and Practice

Shoulder dystocia is an emergency obstetric condition which can unpredictable and unpreventable by serious maternal and neonatal complications in approximately 0.15-2.0% of all births. The detection and management of shoulder dystocia is an important issue in midwifery education and practice because it requires advanced midwifery and obstetric knowledge and skills. The aim of this study prepared based on the literature is to share current information about shoulder dystocia and its management. Shoulder dystocia is defined as failure of the birth of the shoulders after the birth of the fetus head. This condition may be the result of a mismatch between the shoulder size of the fetus and the pelvic inlet either as it may occur as jam of anterior or posterior shoulder, or both shoulders. Fetal macrosomia is the most important risk factor for shoulder dystocia. Shoulder dystocia can be successfully managed by midwives and physicians with adequate technical knowledge and skills by the choice and use of appropriate approaches. It has been reported in literature that the maneuvers used in the management of shoulder dystocia are defined as primary, secondary and tertiary, while the most commonly used maneuvers are McRoberts, Rubin, Wood and Gaskin. However, in terms of efficiency and safety, no maneuver has superiority over one another. Which intervention will be used may vary depending on the knowledge, preference and experience who assisted delivery. However, the intervention should be more invasive than the least invasive. As a result, it occurs that shoulder dystocia is an important condition with very serious maternal and neonatal consequences which can unpredictable and unpreventable. Better results can be achieved by providing midwives with skills in the management of shoulder dystocia through simulation training or by improving existing knowledge and skills and by establishing an evidence-based standardization of management of the process