Issue link: http://digitaleditions.uberflip.com/i/1388210
111 Maternity and Obstetrics Shoulder dystocia is diagnosed at vaginal delivery when the anterior shoulder fails to deliver on the first attempt at routine axial traction. Nullips Multips 2020 2019 2018 2017 2016 2015 2014 Number of cases 19 21 40 51 52 71 67 73 59 Incidence of shoulder dystocia 19/1415 1.3% 21/2632 0.8% 40/4047 1.0% 0.9% 0.7% 1.1% 1.1% 1.1% 0.9% Spontaneous labour 11 14 25 31 25 47 43 40 37 Spontaneous vaginal delivery 4 15 19 21 19 25 27 32 24 Operative vaginal delivery 15 6 21 30 33 47 40 41 35 Birthweight >4000g 10 12 22 31 30 45 41 45 41 Procedures to assist delivery of shoulders Nullips Multips 2020 2019 2018 2017 2016 2015 2014 None 0 0 0 0 0 0 0 0 0 McRoberts 1 9 10 5 1 11 8 10 5 All Fours 0 0 0 0 0 2 0 0 0 McRoberts and suprapubic pressure 7 7 14 21 29 27 33 39 33 McRoberts and suprapubic pressure and internal rotation 2 0 2 1 3 3 0 1 5 McRoberts and suprapubic pressure and delivery of posterior arm 2 1 3 17 6 13 17 12 10 McRoberts and suprapubic pressure and internal rotation and delivery of posterior arm 4 1 5 2 7 5 9 5 4 McRoberts and posterior arm 3 3 6 5 0 4 0 4 1 Internal Manoeuvre only 0 0 0 0 4 0 0 0 1 Mc Roberts & Internal rotation 0 0 0 0 2 0 0 1 - Position of head at delivery Nullips Multips 2020 2019 2018 2017 2016 2015 2014 ROT 7 13 20 30 30 29 29 37 29 LOT 11 7 18 19 22 38 38 35 28 Charts not available 1 1 2 2 0 5 0 1* 2 Maternal Complications Nullips Multips 2020 2019 2018 2017 2016 2015 2014 Postpartum haemorrhage >500ml 6 2 8 17 10 18 14 12 10 Third or fourth degree tear 0 1 1 2 1 7 2 6 2 * includes episiotomy & sphincter damage Shoulder Dystocia NMH Annual Rep t | 2020