What is ACOG (American College of Obstetricians and Gynecologists) Doing About Shoulder Dystocia?

-link">occurrence. But since shoulder dystocia and resultant
A shoulder dystocia emergency during birth can havebrachial plexus injuries are very difficult to predict,
disastrous consequences for the baby if not handledACOG training for doctors also aims to teach doctors
properly. Since the baby’s head is alreadyhow best to resolve shoulder dystocia and prevent
delivered but its shoulders are stuck behind thefetal injuries.
mother’s pelvis, there is a strong possibility ofIn addition to the above, ACOG seminars also aim to
the baby dying from suffocation if too much timemake doctors aware about the many medico-legal
elapses and the shoulder dystocia is not resolved.aspects regarding shoulder dystocia and brachial
A shoulder dystocia emergency during birth can haveplexus injuries. Shoulder dystocia lawsuits are
disastrous consequences for the baby if not handleddiscussed as well as the various claims that can be
properly. Since the baby's head is already delivered butmade against doctors if fetal injuries do occur. Since
its shoulders are stuck behind the mother's pelvis, theredoctors are made aware of the huge potential for
is a strong possibility of the baby dying fromexpensive litigation in the form of brachial plexus injury
suffocation if too much time elapses and the shoulderlawsuit, it does make them try that much harder to
dystocia is not resolved.prevent shoulder dystocia and conditions such as Erb's
In truth, sometimes even if doctors are able to resolvepalsy.
the dystocia using one of the many maneuvers forInformation For Parents For Prevention Of Brachial
handling shoulder dystocia, far too frequently brachialPlexus Injuries
plexus injuries are sustained by the baby. Such injuriesApart from training doctors and conducting clinical
affect the movement of the arm and hands and mayseminars, ACOG is also involved in educating parents
even leave the baby's arm paralyzed for life. Thoughabout everything related to shoulder dystocia and
some statistics suggest that this occurs in only two tobrachial plexus injuries. By providing relevant information
five babies per every 1000 live births, as far as we areto parents, ACOG is trying to make them more aware
concerned that is two to five babies too many.of such birthing emergencies and what parents can do
Fortunately, ACOG (American College of Obstetriciansto prevent fetal or birth injuries to their babies.
and Gynecologists) has recognized the seriousness ofThe ACOG regularly releases for parents practice
this birthing emergency and is taking many steps tobulletins that contain the most updated should dystocia
ensure that brachial plexus injuries from shoulderinformation. These bulletins contain information that can
dystocia can be reduced. Here's a look at whathelp mothers to understand whether they may be at
ACOG is doing about shoulder dystocia. Training Foran increased risk for shoulder dystocia. If the risk of
Doctors For Prevention Of Brachial Plexus Injuriesdystocia and brachial plexus injuries is high, parents are
ACOG has many different training and educationaladvised as to the best way to reduce such risk and
programs for doctors and health care practitioners toensure the birth of a healthy baby.
help prevent brachial plexus injuries. They routinelyTwo main risk factors for shoulder dystocia are
conduct clinical seminars on the subject ofmaternal diabetes and fetal macrosomia. ACOG has
‘Managing Shoulder Dystocia', which help to educateissued practice bulletins on these two topics so that
doctors on the following topics:parents can manage gestational diabetes properly and
- Is it possible to predict shoulder dystocia?also perhaps opt for a cesarean delivery if the fetus is
- Is shoulder dystocia preventable?macrosomic (excessively large). Here are the ACOG
- When the emergency does occur, is it possible toguidelines on these two topics:
resolve shoulder dystocia without causing any fetal1. ACOG Guidelines For Fetal Macrosomia: The
injury or brachial plexus injuries?recommendations are:
- Is excess traction, applied by the doctor, the reason- Cesarean delivery is indicated when the weight of
for all brachial plexus injuries?the fetus is more than 4500 grams.
By taking part in such seminars and completing the- Women who are not diabetic should consider
training courses, obstetricians and other health carecesarean deliveries if the weight of their fetus is more
givers are then able to:than 5000 grams. For diabetic women the fetal weight
- Identify the various risk factors for shoulder dystociafor cesarean consideration is 4500 grams.
and take measures to prevent it if there is an2. ACOG Guidelines For Management Of Gestational
increased risk of dystocia.Diabetes: The recommendations are:
- Resolve shoulder dystocia (if it occurs) in the best- Mothers should take the laboratory-screening test for
possible manner using the various maneuvers forgestational diabetes between 24 and 28 weeks of
handling dystocia.pregnancy.
- Understand why brachial plexus injuries occur,- If gestational diabetes is present, ask the obstetrician
especially due to the application of excessive traction.about the best manner in which to manage this
With better understanding of these reasons there iscondition during pregnancy.
higher chance of resolving shoulder dystocia withoutACOG also recommends that women who have
brachial plexus injuries.gestational diabetes and whose fetus weighs more
ACOG also has videos on shoulder dystocia thatthan 4500 grams should seriously consider a cesarean
show doctors how to recognize the emergency in thedelivery as this reduces the risk of brachial plexus
labor room and how they can help reposition mothersinjuries greatly.
so as to widen their birth canal to the maximum andThe clinical seminars, practice bulletins and training
help the baby to be delivered without brachial plexusprograms issued by the ACOG for doctors and
injuries such as Erb's palsy.parents therefore greatly assist in lessening the
Therefore, ACOG is doing all in its power to furthernumber of brachial plexus injuries from shoulder
educate doctors about all aspects of shoulderdystocia.
dystocia, including new ways to predict and prevent its