Reported April 20, 2009

Software Makes Childbirth Safer -- Research Summary

BACKGROUND: Shoulder dystocia takes place when a baby gets stuck by the shoulders
behind the mother's pelvic bone during delivery. This happens when a baby is already in the birth
canal, so to ease the baby out, a doctor has to do immediate maneuvers. Shoulder dystocia is
described in an American Family Physician research article as "one oI the most Irightening
emergencies in the delivery room." Authors wrote, "Although many Iactors have been associated
with shoulder dystocia, most cases occur with no warning." Risk Iactors Ior shoulder dystocia
include having diabetes, being overweight, carrying a large baby and having a history oI births
with shoulder dystocia.
While some cases oI shoulder dystocia are overcome without injury to the baby, 20 percent cause
injury, according to shoulderdystociainIo.com. These injuries include collar bone Iractures,
humerus Iractures, contusions, lacerations, birth asphyxia and damage to the brachial plexus
nerves. The brachial plexus nerves are Iound at the base oI the neck. When the nerves are
damaged, a baby can suIIer paralysis oI the arm and hand.
TREATMENT: The majority oI brachial plexus injuries resolve on their own over the course oI
several months to a year, but physical therapy is usually recommended Iollowing birth. For
permanent injuries, physical therapy can strengthen nerves that are partially damaged. Although
some surgeries, like nerve graIting and muscle transposition, are carried out aIter these types oI
injuries, their eIIectiveness remains controversial.
IS IT PREVENTABLE? Traditional thought is that shoulder dystocia is unpredictable and
unpreventable. However, the United Brachial Plexus Network says using the proper positioning
during labor will help reduce the chances oI shoulder dystocia. To prevent the complication,
experts recommend a mother not lie on her tailbone during delivery. This is because the position
reduces the amount oI space a baby has to pass through and increases the likelihood oI a Iorceps
or vacuum delivery. In some cases, a woman who presents multiple risk Iactors Ior shoulder
dystocia is told a C-section is the saIest option Ior delivery.
A NEW WAY TO PREDICT: Dr. Emily Hamilton oI Montreal has developed an algorithm
that, using multiple pieces oI data about a pregnant mother and her baby, can calculate a
probability oI shoulder dystocia with injury occurring. She took this algorithm and developed a
soItware system called CALM Shoulder Screen, which is now being utilized by obstetricians
throughout the United States. The Web-based system can be used to predict a woman's risk oI
shoulder dystocia during birth Irom 37 weeks oI gestation onward. Henry Lerner, M.D.,
Assistant Clinical ProIessor oI Obstetrics and Gynecology at Harvard Medical School in Boston,
Mass., was involved in the testing oI the soItware aIter it was Iirst developed but no longer
works Ior the company. He still uses it in his practice
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New Trends about
MaternaI & ChiId
"Software Makes
ChiIdbirth Safer"


Regine C. Roxas
A 404
Mrs. Jogi Reyes RN MAN