Christie, Loxley R.; Harriott, John A.; Mitchell, Sharmaine Y.; Fletcher, Horace M.; Bambury, Ian G.
Author Affiliation, Ana.
Shoulder Dystocia in a Jamaican Cohort.
International Journal of Gynaecology and Obstetrics
Date of Publication
Objective: To assess the risk factors for shoulder dystocia in Jamaica. Methods: A retrospective cohort analysis of all cases of shoulder dystocia, and birth weight-matched controls identified from January 1, 2000 to December 31, 2004. Multiple factors were analyzed individually and in combination to identify risk factors. Results: The incidence of shoulder dystocia was 0.83%. Nulliparity, a first stage of labor greater than 7 hours, a second stage lasting more than 1 hour, and use of oxytocin augmentation were found to be statistically significant factors with unadjusted odds ratios (95% confidence interval) of 1.78 (0.86–3.34), 1.89 (0.91–3.94), 2.78 (0.24–31.47), and 1.56 (0.77–3.15), respectively. The incidence of shoulder dystocia decreased as parity increased when adjusted for age. Conclusion: Individual risk factors for shoulder dystocia remain obscure. The nulliparous pelvis, when controlled for neonatal weight, was associated with a statistically increased risk of shoulder dystocia; this risk decreased with increasing parity.....