Long-term trends in the incidence and management of shoulder dystocia in a tertiary obstetric unit in Hong Kong
Because there have been changes in the management of macrosomic pregnancies and shoulder dystocia in the past decade, this study was conducted to compare the incidences of shoulder dystocia and perinatal outcomes between the periods of 2000-2009 and 2010-2019. This retrospective study was conducted...
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| Veröffentlicht in: | Hong Kong Medical Journal 2023-12, Vol.29 (6), p.524-531 |
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| creator | Chan, E H L Lau, S L Leung, T Y |
| description | Because there have been changes in the management of macrosomic pregnancies and shoulder dystocia in the past decade, this study was conducted to compare the incidences of shoulder dystocia and perinatal outcomes between the periods of 2000-2009 and 2010-2019.
This retrospective study was conducted in a tertiary obstetric unit. All cases of shoulder dystocia were identified using the hospital's electronic database. The incidences, maternal and fetal characteristics, obstetric management methods, and perinatal outcomes were compared between the two study periods.
The overall incidence of shoulder dystocia decreased from 0.23% (134/58 326) in 2000-2009 to 0.16% (108/65 683) in 2010-2019 (P=0.009), mainly because of the overall decline in the proportion of babies with macrosomia (from 3.3% to 2.3%; P |
| doi_str_mv | 10.12809/hkmj2210038 |
| format | Article |
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This retrospective study was conducted in a tertiary obstetric unit. All cases of shoulder dystocia were identified using the hospital's electronic database. The incidences, maternal and fetal characteristics, obstetric management methods, and perinatal outcomes were compared between the two study periods.
The overall incidence of shoulder dystocia decreased from 0.23% (134/58 326) in 2000-2009 to 0.16% (108/65 683) in 2010-2019 (P=0.009), mainly because of the overall decline in the proportion of babies with macrosomia (from 3.3% to 2.3%; P<0.001). The improved success rates of the McRoberts' manoeuvre (from 31.3% to 47.2%; P=0.012) and posterior arm extraction (from 52.9% to 92.3%; P=0.042) allowed a greater proportion of affected babies to be delivered within 2 minutes (from 59.0% to 79.6%; P=0.003). These changes led to a significant reduction in the proportion of fetuses with low Apgar scores: <5 at 1 minute of life (from 13.4% to 5.6%; P=0.042) and <7 at 5 minutes of life (from 11.9% to 4.6%; P=0.045).
More proactive management of macrosomic pregnancies and enhanced training in the acute management of shoulder dystocia led to significant improvements in shoulder dystocia incidence and perinatal outcomes from 2000-2009 to 2010-2019.</description><identifier>ISSN: 1024-2708</identifier><identifier>EISSN: 2226-8707</identifier><identifier>DOI: 10.12809/hkmj2210038</identifier><identifier>PMID: 37704569</identifier><language>eng</language><publisher>China: Hong Kong Academy of Medicine</publisher><subject>Apgar score ; Birth weight ; Body mass index ; Brachial plexus ; Cesarean section ; Childbirth & labor ; Diabetes ; Hypoxia ; Induced labor ; Ischemia ; Obstetrics ; Pregnancy ; Stillbirth ; Success ; Vagina</subject><ispartof>Hong Kong Medical Journal, 2023-12, Vol.29 (6), p.524-531</ispartof><rights>2023. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37704569$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chan, E H L</creatorcontrib><creatorcontrib>Lau, S L</creatorcontrib><creatorcontrib>Leung, T Y</creatorcontrib><title>Long-term trends in the incidence and management of shoulder dystocia in a tertiary obstetric unit in Hong Kong</title><title>Hong Kong Medical Journal</title><addtitle>Hong Kong Med J</addtitle><description>Because there have been changes in the management of macrosomic pregnancies and shoulder dystocia in the past decade, this study was conducted to compare the incidences of shoulder dystocia and perinatal outcomes between the periods of 2000-2009 and 2010-2019.
This retrospective study was conducted in a tertiary obstetric unit. All cases of shoulder dystocia were identified using the hospital's electronic database. The incidences, maternal and fetal characteristics, obstetric management methods, and perinatal outcomes were compared between the two study periods.
The overall incidence of shoulder dystocia decreased from 0.23% (134/58 326) in 2000-2009 to 0.16% (108/65 683) in 2010-2019 (P=0.009), mainly because of the overall decline in the proportion of babies with macrosomia (from 3.3% to 2.3%; P<0.001). The improved success rates of the McRoberts' manoeuvre (from 31.3% to 47.2%; P=0.012) and posterior arm extraction (from 52.9% to 92.3%; P=0.042) allowed a greater proportion of affected babies to be delivered within 2 minutes (from 59.0% to 79.6%; P=0.003). These changes led to a significant reduction in the proportion of fetuses with low Apgar scores: <5 at 1 minute of life (from 13.4% to 5.6%; P=0.042) and <7 at 5 minutes of life (from 11.9% to 4.6%; P=0.045).
More proactive management of macrosomic pregnancies and enhanced training in the acute management of shoulder dystocia led to significant improvements in shoulder dystocia incidence and perinatal outcomes from 2000-2009 to 2010-2019.</description><subject>Apgar score</subject><subject>Birth weight</subject><subject>Body mass index</subject><subject>Brachial plexus</subject><subject>Cesarean section</subject><subject>Childbirth & labor</subject><subject>Diabetes</subject><subject>Hypoxia</subject><subject>Induced labor</subject><subject>Ischemia</subject><subject>Obstetrics</subject><subject>Pregnancy</subject><subject>Stillbirth</subject><subject>Success</subject><subject>Vagina</subject><issn>1024-2708</issn><issn>2226-8707</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNpdkT1PwzAQhi0EoqWwMSNLLAwEbMexnRFVQBGVWGCOHOfSpjQ22M7Qf49LC0Isd9Ldc-99IXROyQ1lipS3y_d-xRglJFcHaMwYE5mSRB6iMSWMZ0wSNUInIawIYaooyTEa5VISXohyjNzc2UUWwfc4erBNwJ3FcQnJma4BawBr2-BeW72AHmzErsVh6YZ1Ax43mxCd6fS2SOOkEjvtN9jVIUL0ncGD7eI2OUtd8HMyp-io1esAZ3s_QW8P96_TWTZ_eXya3s0zk1MeM8FVKUBoDabglEteC06kLJgs2hTVtGZCg1aUmrRjIVhpSiiVaQoCKVvkE3S10_3w7nOAEKu-CwbWa23BDaFiatuipEwk9PIfunKDt2m6KqeUUZnnXCbqekcZ70Lw0FYfvuvTthUl1fcjqj-PSPjFXnSoe2h-4Z_L51_cIINo</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Chan, E H L</creator><creator>Lau, S L</creator><creator>Leung, T Y</creator><general>Hong Kong Academy of Medicine</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BVBZV</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PIMPY</scope><scope>PKEHL</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20231201</creationdate><title>Long-term trends in the incidence and management of shoulder dystocia in a tertiary obstetric unit in Hong Kong</title><author>Chan, E H L ; Lau, S L ; Leung, T Y</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c314t-64896e6aaec541474b640775275f6aaa1b26aea811c0245629c9e98cd50eaa153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Apgar score</topic><topic>Birth weight</topic><topic>Body mass index</topic><topic>Brachial plexus</topic><topic>Cesarean section</topic><topic>Childbirth & labor</topic><topic>Diabetes</topic><topic>Hypoxia</topic><topic>Induced labor</topic><topic>Ischemia</topic><topic>Obstetrics</topic><topic>Pregnancy</topic><topic>Stillbirth</topic><topic>Success</topic><topic>Vagina</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chan, E H L</creatorcontrib><creatorcontrib>Lau, S L</creatorcontrib><creatorcontrib>Leung, T Y</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>East & South Asia Database</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Hong Kong Medical Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chan, E H L</au><au>Lau, S L</au><au>Leung, T Y</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term trends in the incidence and management of shoulder dystocia in a tertiary obstetric unit in Hong Kong</atitle><jtitle>Hong Kong Medical Journal</jtitle><addtitle>Hong Kong Med J</addtitle><date>2023-12-01</date><risdate>2023</risdate><volume>29</volume><issue>6</issue><spage>524</spage><epage>531</epage><pages>524-531</pages><issn>1024-2708</issn><eissn>2226-8707</eissn><abstract>Because there have been changes in the management of macrosomic pregnancies and shoulder dystocia in the past decade, this study was conducted to compare the incidences of shoulder dystocia and perinatal outcomes between the periods of 2000-2009 and 2010-2019.
This retrospective study was conducted in a tertiary obstetric unit. All cases of shoulder dystocia were identified using the hospital's electronic database. The incidences, maternal and fetal characteristics, obstetric management methods, and perinatal outcomes were compared between the two study periods.
The overall incidence of shoulder dystocia decreased from 0.23% (134/58 326) in 2000-2009 to 0.16% (108/65 683) in 2010-2019 (P=0.009), mainly because of the overall decline in the proportion of babies with macrosomia (from 3.3% to 2.3%; P<0.001). The improved success rates of the McRoberts' manoeuvre (from 31.3% to 47.2%; P=0.012) and posterior arm extraction (from 52.9% to 92.3%; P=0.042) allowed a greater proportion of affected babies to be delivered within 2 minutes (from 59.0% to 79.6%; P=0.003). These changes led to a significant reduction in the proportion of fetuses with low Apgar scores: <5 at 1 minute of life (from 13.4% to 5.6%; P=0.042) and <7 at 5 minutes of life (from 11.9% to 4.6%; P=0.045).
More proactive management of macrosomic pregnancies and enhanced training in the acute management of shoulder dystocia led to significant improvements in shoulder dystocia incidence and perinatal outcomes from 2000-2009 to 2010-2019.</abstract><cop>China</cop><pub>Hong Kong Academy of Medicine</pub><pmid>37704569</pmid><doi>10.12809/hkmj2210038</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Apgar score Birth weight Body mass index Brachial plexus Cesarean section Childbirth & labor Diabetes Hypoxia Induced labor Ischemia Obstetrics Pregnancy Stillbirth Success Vagina |
| title | Long-term trends in the incidence and management of shoulder dystocia in a tertiary obstetric unit in Hong Kong |
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