This document discusses shoulder dystocia, which occurs in approximately 1% of vaginal births and complicates delivery. Fetal macrosomia and maternal diabetes are known risk factors, but shoulder dystocia remains largely unpredictable. While the risk increases with higher birthweights, especially over 4500g, ultrasound and clinical estimates of fetal weight are inaccurate in predicting macrosomia. A history of prior shoulder dystocia or maternal diabetes also increase the risk of recurrence. However, due to the inability to reliably predict shoulder dystocia, preventative cesarean sections are not recommended. Patients with risk factors require careful management and counseling regarding delivery.
Vai trò của chỉ số não rốn trong đánh giá sức khỏe thai nhi ở thai AGA và SGA Võ Tá Sơn
Vai trò của chỉ số não rốn trong đánh giá sức khỏe thai nhi ở thai AGA và SGA
The importance of the cerebroplacental ratio in the evaluation of fetal well-being in SGA and AGA fetuses
Vai trò của chỉ số não rốn trong đánh giá sức khỏe thai nhi ở thai AGA và SGA Võ Tá Sơn
Vai trò của chỉ số não rốn trong đánh giá sức khỏe thai nhi ở thai AGA và SGA
The importance of the cerebroplacental ratio in the evaluation of fetal well-being in SGA and AGA fetuses
PART 2 MRCOG INTENSIVE REVISION COURSE
AMMAN, JORDAN23-25 JANUARY 2017
Module 11: Management of delivery
Dr.5: Hashem Yaseen, MBBS, 4th year OG resident
Jordan University of Science and Technology, King Abdullah University Hospital,
Hashemmail@yahoo.com
Fetal growth restriction (FGR), formerly called intrauterine growth restriction (IUGR), refers to a condition in which an unborn baby is smaller than it should be because it is not growing at a normal rate inside the womb.
Mild FGR usually doesn't cause long-term problems. In fact, most babies who have it catch up in height and weight by age 2. But severe FGR can seriously harm a baby before and after birth. The extent of the problems depends on the cause and how severe the growth restriction is. It also depends on what point in the pregnancy it starts.
PART 2 MRCOG INTENSIVE REVISION COURSE
AMMAN, JORDAN23-25 JANUARY 2017
Module 11: Management of delivery
Dr.5: Hashem Yaseen, MBBS, 4th year OG resident
Jordan University of Science and Technology, King Abdullah University Hospital,
Hashemmail@yahoo.com
Fetal growth restriction (FGR), formerly called intrauterine growth restriction (IUGR), refers to a condition in which an unborn baby is smaller than it should be because it is not growing at a normal rate inside the womb.
Mild FGR usually doesn't cause long-term problems. In fact, most babies who have it catch up in height and weight by age 2. But severe FGR can seriously harm a baby before and after birth. The extent of the problems depends on the cause and how severe the growth restriction is. It also depends on what point in the pregnancy it starts.
ABSTRACT- Placenta is the mirror of fetomaternal status. The effect of anemia in pregnancy can be diverse and detrimental to the mother and the fetus. This prompted us to carry out the present study, which aimed to observe and compare the morphological features of placenta at term in anemic and non-anemic mothers of North Bengal and to find out the clinical relevance of such structural changes. Total 30 placentas were collected from each group of selected patients after delivery at labor room. Examination of placenta was conducted according to proforma. A general survey of umbilical cord, membranes, fetal surface, and maternal surface was carried out. The diameters were measured, area was estimated, and shape was noted. Placenta and fetus was weighed in the same scale. The volume was estimated by water displacement method. In anemic mothers, mean baby birth weight was found to be significantly less than that of control group. The mean placental weight in test group was significantly increased in comparison to controls. The mean placental volume and mean placental area in case of test group were significantly increased. Occurrence of morphological features, like subchorionic fibrosis; retroplacental clot, gross calcification, or placental infarction etc were found to be significantly higher in anemic mothers in comparison to non-anemic group. In the present study, it was proved that placenta has considerable functional reserve capacity. It tends to limit the ill-effects of tissue injury and of unfavorable maternal milieu like anemia. Our findings were in accordance with the previous studies in this field. Key-words- Placenta, Maternal anaemia, Morphological changes, Placental weight
prophylactic encerclage for multiple pregnancy is always debated.in this presentation cerclage for MFG is favored as there was a debate in recently held KSOGA conference at manipal on 3-11-11.
Frequency of C-Section vs SVD, Necessity or Malpractice Hussain Karimi
Previous vaginal delivery gives the family and the doctors a false sense of security that overshadows the need for vigilant antenatal and intrapartum care. The method of previous deliveries shouldn’t be the primary criteria upon which the current delivery is decided. Rather, every pregnancy should be treated with as much concern and care as the first. (the physicians should display obligation In such circumstances and assess the pregnancy thoroughly before heading towards a massive scheme. Rather than promoting the doctors’ own interests and convenience, Mothers’ health and wellbeing should be considered the first priority and every possible measures should be taken to ensure that. The antenatal care should be the utmost preference and necessary investigations should be practiced. WHO recommends a minimum of four antenatal visits, comprising interventions such as tetanus toxoid vaccination, screening and treatment for infections, and identification of warning signs during pregnancy. With all the adequate steps taken, the rate and reasons of cesarean sections could be monitored and restricted hence progressing to initiate a huge stride for maternal and fetal health.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
1. Shoulder Dystocia:
Incidence and Risk
Factors
JOSEPH G. OUZOUNIAN, MD
University of Southern California, Keck School of Medicine,
Los Angeles, California
Abstract: Shoulder dystocia complicates B1% of
vaginal births. Although fetal macrosomia and ma-
ternal diabetes are risk factors for shoulder dystocia,
for the most part its occurrence remains largely
unpredictable and unpreventable.
Key words: macrosomia, shoulder dystocia, gesta-
tional diabetes
The most common definition for should-
er dystocia is a delivery that requires
additional obstetric maneuvers after gen-
tle downward traction on the fetal head is
unsuccessful in delivery of the shoulders.1
Careful review of 29 peer-reviewed stud-
ies published from 1985 to 2016 demon-
strates an incidence of shoulder dystocia
ranging from 0.1% to 3.0% of all deliv-
eries, with a clinically useful average
incidence of about 1%.1–29
This wide
range may be attributable to variations
in the study populations analyzed, incon-
sistencies in shoulder dystocia diagnosis,
and methodologic variation (eg, reliance
on medical record coding vs. direct med-
ical record review, etc.).
Although the majority of shoulder
dystocia cases occur in infants with birth-
weight less than 4000 g, fetal macrosomia
increases the risk for shoulder dysto-
cia.1,18
In 2013, Ouzounian et al18
studied
221 cases of shoulder dystocia from a
cohort of 13,277 vaginal deliveries, and
demonstrated that more than half
(50.7%) occurred in infants that weighed
<4000 g. However, the mean birthweight
in the shoulder dystocia group was
4011 ± 452 versus 3390 ± 447 g in the
no shoulder dystocia group (P<0.001).
Furthermore, <1% of the nonshoulder
dystocia patients had a birthweight
>4500 g, compared with 14.5% in the
shoulder dystocia group (P<0.001). Oth-
er investigators have demonstrated sim-
ilar trends. For example, at least 2 studies
showed that the incidence of shoulder
dystocia increases with every 500 g of
birthweight, with a 10-fold increased
incidence when birthweight was over
4500 g.30,31
In fact, in Stotland’s
study, the incidence of shoulder dystocia
was 23% when birthweight was over
5000 g.31
Although the association of high birth-
weight and shoulder dystocia is indeedThe author declares that they have nothing to disclose.
Correspondence: Joseph G. Ouzounian, MD, Univer-
sity of Southern California, Keck School of Medicine,
Los Angeles, CA. E-mail: joseph.ouzounian@med.
usc.edu
CLINICAL OBSTETRICS AND GYNECOLOGY / VOLUME 59 / NUMBER 4 / DECEMBER 2016
www.clinicalobgyn.com | 791
CLINICAL OBSTETRICS AND GYNECOLOGY
Volume 59, Number 4, 791–794
Copyright r 2016 Wolters Kluwer Health, Inc. All rights reserved.
Copyright r 2016 Wolters Kluwer Health, Inc. All rights reserved.
2. compelling, it remains a clinical conun-
drum for contemporaneous patient man-
agement, in light of our continued
inability to predict birthweight accurately
using either ultrasound or clinical meth-
ods. Typically, ultrasound estimates of
fetal weight are within 20% of the actual
birthweight in 95% of cases. In the
remaining 5%, the estimate will have an
error rate >20%.32,33
Clinical estimates
using abdominal palpation, fundal height,
or maternal estimation do not perform
any better. In a recent study evaluating
the effects of suspected macrosomia on
outcome, King and colleagues demon-
strated that the sensitivity of ultrasound
and abdominal palpation for identifying
macrosomia before delivery was 40.2%
and 15.1%, respectively. Furthermore,
most studies evaluating the relationship
between fetal macrosomia and birth-
weight use actual birthweight to describe
the association.
To help clarify this matter further, in
2016 Ouzounian et al2
studied clinical
risk factors for shoulder dystocia and
compared risk factor prediction models
using estimated fetal weight versus actual
birthweight. The risk factor models were
analyzed rigorously using multivariable
logistic regression techniques, and neither
model demonstrated clinically useful sen-
sitivity or positive predictive value for
unequivocal prediction of shoulder dys-
tocia before delivery.2
Even with these
limitations in mind, it is generally helpful
to have a good faith estimate of fetal
weight before delivery to assist with
patient counseling, delivery planning,
and intrapartum management. The
American College of Obstetricians and
Gynecologists has set forth clinical
thresholds of 4500 and 5000 g (for dia-
betics and nondiabetics, respectively).34
Thus, in a hypothetical example where a
patient has a clinical fetal weight estimate
of 4400 g, after appropriate counseling
vaginal delivery might still be attempted,
but the estimate may trigger an informed
consent discussion before delivery, and
may also preclude an attempt at opera-
tive vaginal delivery with forceps or
vacuum intrapartum.
Maternal diabetes is another risk fac-
tor for shoulder dystocia.35
Maternal
diabetes, whether gestational or pregesta-
tional, can result in fetal macrosomia,
which is a risk factor for shoulder dysto-
cia in and of itself as discussed above. In
addition, when compared side by side,
infants of diabetic mothers have an in-
creased risk for shoulder dystocia even
with normal birthweight, due to the
potential dysmorphic features often seen
in these infants. Physiologically, infants
of diabetic mothers have thicker upper
extremity skinfolds, higher body fat, and
broader shoulders. They also have an
increased incidence of asymmetric growth
patterns. These findings, taken together,
can result in an increased risk for should-
er dystocia.36–41
Although the diagnosis
of maternal diabetes does not preclude
vaginal delivery in and of itself, it may
warrant careful fetal weight estimation,
informed consent, and individualized
delivery planning.
A history of prior shoulder dystocia is
an important risk factor for recurrence.
Studies of recurrent shoulder dystocia
consistently have demonstrated increased
rates of shoulder dystocia in subsequent
pregnancies. The rate may be even higher
than reported, given that many patients
who had shoulder dystocia in a prior
pregnancy may not have additional chil-
dren, or may deliver through cesarean
section in a subsequent pregnancy. Thus,
while the true rate for recurrence may not
be completely evident, studies have dem-
onstrated a range from 1% to 17%, with
most studies citing an incidence of at least
10%.42,43
Although a history of prior
shoulder dystocia is not an absolute
contraindication to subsequent vaginal
delivery, these patients must be evaluated
carefully, taking into account patient
autonomy, prior pregnancy history, and
792 Ouzounian
www.clinicalobgyn.com
Copyright r 2016 Wolters Kluwer Health, Inc. All rights reserved.
3. future reproductive plans, and providing
thorough informed consent counseling
before delivery.
Other purported obstetric risk factors
for shoulder dystocia include excessive
maternal weight or weight gain, operative
vaginal delivery, oxytocin use, multipar-
ity, epidural use, and abnormal labor.1
Most of these factors may lead to or
actually result from excess fetal weight.
Moreover, while many of them have been
described in conjunction with shoulder
dystocia, that association cannot be
equated as a causative link. For example,
the rate of epidural use for pain relief in
labor continues to increase in the United
States, but the rate of shoulder dystocia
has remained essentially constant. Equally
important, recent studies that have ana-
lyzed these risk factors alone or in com-
bination have shown that they are poor
predictors for the occurrence of shoulder
dystocia.44,45
For example, in a 2005
study of over 1600 cases of shoulder
dystocia, Ouzounian and Gherman45
showed that the clinical triad of labor
induction, oxytocin use, and birthweight
greater than 4500 g had a sensitivity and
positive predictive value of 12.4% and
3.4%, respectively, for the occurrence of
shoulder dystocia.
For the most part, shoulder dystocia
remains an unpredictable and unprevent-
able event. Although prophylactic cesar-
ean section to avoid shoulder dystocia
may be an option in some cases, policies
of planned cesarean section for suspected
macrosomia have not been practical, and
can result in unnecessary cost as well as
increased maternal morbidity.46
Patients
with one or more risk factors should be
counseled, monitored and managed care-
fully, however, to maximize maternal and
neonatal outcomes.
References
1. Gherman RB, Chauhan S, Ouzounian JG, et al.
Shoulder dystocia: the unpreventable obstetric
emergency with empiric management guidelines.
Am J Obstet Gynecol. 2006;195:657–672.
2. Ouzounian JG, Korst LM, Sanchez M, et al.
Clinical risk factors do not predict shoulder
dystocia. J Reprod Med. 2016. (In press).
3. Soni AL, Mir NA, Kishan J, et al. Brachial
plexus injuries in babies born in hospital: an
appraisal of risk factors in a developing country.
Ann Trop Paediatr. 1985;5:69–71.
4. Jennett RJ, Tarby TJ, Kreinick CJ. Brachial
plexus palsy: an old problem revisited. Am J
Obstet Gynecol. 1992;166:1673–1676. Discussion
1676–1677.
5. Nocon JJ, McKenzie DK, Thomas LJ, et al.
Shoulder dystocia: an analysis of risks and
obstetric maneuvers. Am J Obstet Gynecol.
1993;168:1732–1737. Discussion 1737–1739].
6. Gonen R, Spiegel D, Abend M. Is macrosomia
predictable, and are shoulder dystocia and birth
trauma preventable? Obstet Gynecol. 1996;88:
526–529.
7. Bahar AM. Risk factors and fetal outcome in
cases of shoulder dystocia compared with normal
deliveries of a similar birth-weight. Br J Obstet
Gynaecol. 1996;103:868–872.
8. Gherman RB, Goodwin TM, Ouzounian JG,
et al. Brachial plexus palsy associated with
cesarean section: an in utero injury? Am J Obstet
Gynecol. 1997;177:1162–1164.
9. Ecker JL, Greenberg JA, Norwitz ER, et al. Birth
weight as a predictor of brachial plexus injury.
Obstet Gynecol. 1997;89:643–647.
10. Gherman RB, Ouzounian JG, Goodwin TM.
Obstetric maneuvers for shoulder dystocia and
associated fetal morbidity. Am J Obstet Gynecol.
1998;178:1126–1130.
11. Draycott TJ, Crofts JF, Ash JP, et al. Improving
neonatal outcome through practical shoulder
dystocia training. Obstet Gynecol. 2008;112:
14–20.
12. Foad SL, Mehlman CT, Ying J. The epidemiol-
ogy of neonatal brachial plexus palsy in the
United States. J Bone Joint Surg Am. 2008;90:
1258–1264.
13. Melendez J, Bhatia R, Callis L, et al. Severe
shoulder dystocia leading to neonatal injury: a
case control study. Arch Gynecol Obstet. 2009;
279:47–51.
14. Grobman WA, Miller D, Burke C, et al. Out-
comes associated with introduction of a shoulder
dystocia protocol. Am J Obstet Gynecol. 2011;
205:513–517.
15. Inglis SR, Feier N, Chetiyaar JB, et al. Effects of
shoulder dystocia training on the incidence of
brachial plexus injury. Am J Obstet Gynecol.
2011;204:e1–e6.
16. Walsh JM, Kandamany N, Ni Shuibhne N, et al.
Neonatal brachial plexus injury: comparison of
Shoulder Dystocia 793
www.clinicalobgyn.com
Copyright r 2016 Wolters Kluwer Health, Inc. All rights reserved.
4. incidence and antecedents between 2 decades. Am
J Obstet Gynecol. 2011;204:e1–e6.
17. Paris AE, Greenberg JA, Ecker JL, et al. Is an
episiotomy necessary with a shoulder dystocia?
Am J Obstet Gynecol. 2011;205:e1–e3.
18. Ouzounian JG, Korst LM, Miller DA, et al.
Brachial plexus palsy and shoulder dystocia:
obstetric risk factors remain elusive. Am J Peri-
natol. 2013;30:303–307.
19. Tsur A, Sergienko R, Wiznitzer A, et al. Critical
analysis of risk factors for shoulder dystocia.
Arch Gynecol Obstet. 2012;285:1225–1229.
20. Overland EA, Vatten LJ, Eskild A. Risk of
shoulder dystocia: associations with parity and
offspring birthweight. A popu-lation study of
1,914,544 deliveries. Acta Obstet Gynecol Scand.
2012;91:483–488.
21. Turrentine MA, Ramirez MM. Adverse perinatal
events and subsequent cesarean rate. Obstet
Gynecol. 1999;94:185–188.
22. Olugbile A, Mascarenhas L. Review of shoulder
dystocia at the Birmingham Women’s Hospital.
J Obstet Gynaecol. 2000;20:267–270.
23. Kees S, Margalit V, Schiff E, et al. Features of
shoulder dystocia in a busy obstetric unit.
J Reprod Med. 2001;46:583–588.
24. Gudmundsson S, Henningsson AC, Lindqvist P.
Correlation of birth injury with maternal height
and birthweight. BJOG. 2005;112:764–767.
25. Mollberg M, Hagberg H, Bager B, et al. High
birthweight and shoulder dystocia: the strongest
risk factors for obstetrical brachial plexus palsy
in a Swedish population-based study. Acta Obstet
Gynecol Scand. 2005;84:654–659.
26. Gurewitsch ED, Johnson E, Hamzehzadeh S,
et al. Risk factors for brachial plexus injury with
and without shoulder dystocia. Am J Obstet
Gynecol. 2006;194:486–492.
27. MacKenzie IZ, Shah M, Lean K, et al. Manage-
ment of shoulder dystocia: trends in incidence
and maternal and neonatal morbidity. Obstet
Gynecol. 2007;110:1059–1068.
28. Ford AA, Bateman BT, Simpson LL, et al.
Nationwide data confirms absence of ‘‘July phe-
nomenon’’ in obstetrics: it’ssafe to deliver in July.
J Perinatol. 2007;27:73–76.
29. Backe B, Magnussen EB, Johansen OJ, et al.
Obstetric brachial plexus palsy: a birth injury not
explained by the known risk factors. Acta Obstet
Gynecol Scand. 2008;87:1027–1032.
30. Acker DB, Sachs BP, Friedman EA. Risk factors
for shoulder dystocia. Obstet Gynecol. 1985;66:
762–768.
31. Stotland NE, Caughey AB, Breed EM, et al. Risk
factors and obstetric complications associated
with macrosomia. Int J Gynaecol Obstet. 2004;
87:200–206.
32. Dudley NJ. A systematic review of the ultra-
sound estimation of fetal weight. Ultrasound
Obstet Gynecol. 2005;25:80–89.
33. American College of Obstetricians and Gynecol-
ogists. Practice Bulletin 134, Intrauterine Growth
Restriction. Washington DC: Lippincott & Wil-
liams; 2013.
34. American College of Obstetricians and Gynecol-
ogists. Practice Bulletin 40, Shoulder Dystocia.
Washington DC: Lippincott & Williams; 2010.
35. Langer O, Berkus MD, Huff RW, et al. Shoulder
dystocia: should the fetus weighing greater than
or equal to 4000 grams be delivered by cesarean
section? Am J Obstet Gynecol. 1991;165:831–837.
36. Cohen B, Penning S, Major C, et al. Sonographic
prediction of shoulder dystocia in infants of
diabetic mothers. Obstet Gynecol. 1996;88:10–13.
37. Cohen BF, Penning S, Ansley D, et al. The
incidence and severity of shoulder dystocia cor-
relates with a songraphic measurement of asym-
metry in patients with diabetes. Am J Perinatol.
1999;16:197–201.
38. Modanlou HD, Komatsu G, Dorchester W, et al.
Large-for-gestational age neonates; anthropo-
metric rea-sons for shoulder dystocia. Obstet
Gynecol. 1982;60:417–423.
39. McFarland MB, Trylovich CG, Langer O.
Anthropometric differences in macrosomic in-
fants of diabetic and nondiabetic mothers.
J Maternal Fetal Med. 1998;7:292–295.
40. Casey BM, Lucas MJ, Mcintire DD, et al. Preg-
nancy outcomes in women with gestational dia-
betes compared with the general obstetric
population. Obstet Gynecol. 1997;90:869–873.
41. Keller JD, Lopez-Zeno JA, Dooley SL, et al.
Shoulder dystocia and birth trauma in gesta-
tional diabetes: a five-year experience. Am J
Obstet Gynecol. 1991;165:928–930.
42. Bingham J, Chauhan SP, Hayes E, et al. Recur-
rent shoulder dystocia: A review. Obstet Gynecol
Surv. 2010;65:183–188.
43. Ouzounian JG, Gherman RB, Chauhan S, et al.
Recurrent shoulder dystocia: analysis of inci-
dence and risk factors. Am J Perinatol. 2012;29:
515–518.
44. Revicky V, Mukhopadhyay S, Morris EP, et al.
Can we predict shoulder dystocia? Arch Gynecol
Obstet. 2012;285:291–295.
45. Ouzounian JG, Gherman RB. Shoulder dystocia:
are historic risk factors reliable predictors? Am J
Obstet Gynecol. 2005;192:1933–1938.
46. Rouse DJ, Sonography Owen J. suspected macro-
somia, and prophylactic cesarean: a limited part-
nership. Clin Obstet Gynecol. 2000;43:326–334.
794 Ouzounian
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