{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:19:39Z","timestamp":1791890379526,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,9,14]],"date-time":"2017-09-14T00:00:00Z","timestamp":1505347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2018,6]]},"abstract":"Background<\/jats:title>Shoulder dystocia is an uncommon and unpredictable obstetric emergency. It is associated with significant neonatal, maternal and medico\u2010legal consequences.<\/jats:p><\/jats:sec>Aim<\/jats:title>To ascertain the impact shoulder dystocia has on severe neonatal and maternal outcomes specific to the type of manoeuvre.<\/jats:p><\/jats:sec>Materials and methods<\/jats:title>This was a retrospective study of 48\u00a0021 term singleton vaginal deliveries the Mater Mothers' Hospital in Brisbane between 2007 and 2015. Maternal and neonatal outcomes were compared between deliveries complicated by shoulder dystocia and those uncomplicated.<\/jats:p><\/jats:sec>Results<\/jats:title>Deliveries complicated by shoulder dystocia are associated with low Apgar scores (\u22643) at five minutes (odds ratio (OR)<\/jats:styled-content> 5.25, 95% CI<\/jats:styled-content> 3.23\u20138.56, P<\/jats:italic>\u00a0<\u00a00.001), acidosis (OR<\/jats:styled-content> 3.10, 95% CI<\/jats:styled-content> 2.76\u20133.50, P<\/jats:italic>\u00a0<\u00a00.001), postpartum haemorrhage (OR<\/jats:styled-content> 2.28, 95% CI<\/jats:styled-content> 1.90\u20132.75, P<\/jats:italic>\u00a0<\u00a00.001) and perineal trauma (OR<\/jats:styled-content> 1.92, 95% CI<\/jats:styled-content> 1.54\u20132.39, P<\/jats:italic>\u00a0<\u00a00.001). Compared to McRoberts' manoeuvre and suprapubic pressure alone, the odds of serious neonatal outcome are increased with internal rotational manoeuvres (OR<\/jats:styled-content> 3.82, 95% CI<\/jats:styled-content> 2.54\u20135.74, P<\/jats:italic>\u00a0<\u00a00.001) and delivery of the posterior arm (OR<\/jats:styled-content> 4.49, 95% CI<\/jats:styled-content> 3.54\u20135.69, P<\/jats:italic>\u00a0<\u00a00.001). The OR of maternal injury is 2.07 (95% CI<\/jats:styled-content> 1.77\u20132.45, P<\/jats:italic>\u00a0<\u00a00.001), 2.26 (95% CI<\/jats:styled-content> 1.21\u20134.21, P<\/jats:italic>\u00a0<\u00a00.001) and 2.29 (95% CI<\/jats:styled-content> 1.58\u20133.32, P<\/jats:italic>\u00a0<\u00a00.001) with McRoberts'\/suprapubic pressure, internal rotation and posterior arm delivery, respectively. Brachial plexus injuries and fractures complicate 1.4 and 0.9% of deliveries, with the risk of injury increasing when greater than one manoeuvre is required.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The risk of neonatal and maternal trauma is strongly associated with the number and types of manoeuvres. Given the associated implications, adequate antenatal counselling, simulation training and enhanced labour surveillance are essential.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12718","type":"journal-article","created":{"date-parts":[[2017,9,14]],"date-time":"2017-09-14T08:01:30Z","timestamp":1505376090000},"page":"298-305","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Impact of shoulder dystocia, stratified by type of manoeuvre, on severe neonatal outcome and maternal morbidity"],"prefix":"10.1111","volume":"58","author":[{"given":"Flurina","family":"Michelotti","sequence":"first","affiliation":[{"name":"Mater Mothers' Hospital South Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Flatley","sequence":"additional","affiliation":[{"name":"Mater Research Institute \u2013 University of Queensland South Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0832-4811","authenticated-orcid":false,"given":"Sailesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Mater Mothers' Hospital South Brisbane Queensland Australia"},{"name":"Mater Research Institute \u2013 University of Queensland South Brisbane Queensland Australia"},{"name":"School of Medicine The University of Queensland Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,14]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Royal College of Obstetricians and Gynaecologists.Green\u2010top guideline No. 42 Shoulder Dystocia 2012. [Accessed 28 December 2016.] Available from URL:http:\/\/www.nhsla.com\/safety\/Documents\/Shoulder%20Dystocia%20-%2017.pdf"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(02)90001-9"},{"key":"e_1_2_6_4_1","first-page":"762","article-title":"Risk factors for shoulder dystocia","volume":"66","author":"Acker DB","year":"1985","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.09.007"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31821a12c9"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(93)90684-B"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.05.055"},{"key":"e_1_2_6_9_1","volume-title":"Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth","author":"National Collaborating Centre for Women's and Children's Health (Great Britain), National Institute for Health and Clinical Excellence (Great Britain)","year":"2007"},{"key":"e_1_2_6_10_1","unstructured":"Australia's mothers and babies 2014\u2014in brief. Perinatal statistics series no. 32. Cat no. PER 87.Australian Institute of Health and Welfare Canberra: AIHW 2016."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)91355-6"},{"key":"e_1_2_6_12_1","first-page":"526","article-title":"Shoulder dystocia. A complication of fetal macrosomia and prolonged second stage of labor with midpelvic delivery","volume":"52","author":"Benedetti TJ","year":"1978","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.060"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2012.01425.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2014.04.003"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2004.08.010"},{"key":"e_1_2_6_17_1","first-page":"35","article-title":"Shoulder dystocia: an evidence\u2010based approach","volume":"4","author":"Politi S","year":"2010","journal-title":"J Prenatal Med"},{"key":"e_1_2_6_18_1","unstructured":"NHS Litigation Authority.Maternity Claims \u2013 Information Sheet 17 Shoulder Dystocia 2010. [Accessed 29 December 2016.] Available from URL:http:\/\/www.nhsla.com\/safety\/Documents\/Shoulder%20Dystocia%20-%2017.pdf"},{"key":"e_1_2_6_19_1","first-page":"71","article-title":"The changing paradigm of the doctor\u2010patient relationship: Montgomery v Lanarkshire Health Board and developments in the \u2018duty to warn\u2019","volume":"129","author":"Sizer L","year":"2015","journal-title":"N Z Med J"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0020-7292(88)90198-1"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61904-8"},{"key":"e_1_2_6_22_1","first-page":"CD000938","article-title":"Induction of labour at or near term for suspected fetal macrosomia","author":"Boulvain M","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14435"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001767"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31817bbc61"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000246801.45977.c8"},{"key":"e_1_2_6_27_1","first-page":"322","article-title":"Effects of shoulder dystocia training on the incidence of brachial plexus injury","volume":"204","author":"Inglis SR","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000126816.98387.1c"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.10.904"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000286779.41037.38"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000483626.00192.81"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fajo.12718","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.12718","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T14:36:39Z","timestamp":1695479799000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.12718"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,14]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1111\/ajo.12718"],"URL":"https:\/\/doi.org\/10.1111\/ajo.12718","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,14]]},"assertion":[{"value":"2017-06-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-08-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-09-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}