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

A shoulder dystocia emergency during birth can have
disastrous consequences for the baby if not handled
properly. Since the baby's head is already delivered but
its shoulders are stuck behind the mother's pelvis, there
is a strong possibility of the baby dying from suffocation
if too much time elapses and the shoulder dystocia is not
resolved.

In fact, even when the dystocia is resolved using one of
the many maneuvers for handling shoulder dystocia, very too
often the baby suffers from brachial plexus injuries. Such
injuries affect the movement of the arm and hands and may
even leave the baby's arm paralyzed for life. Although
statistics suggest that this happens in only 2-5 babies in
a 1000 live births, it is still 2-5 babies too many as far
as we are concerned. Fortunately, ACOG (American College of
Obstetricians and Gynecologists) has recognized the
seriousness of this birthing emergency and is taking many
steps to ensure that brachial plexus injuries from shoulder
dystocia can be reduced. Here's a look at what ACOG is
doing about shoulder dystocia. Training For Doctors For
Prevention Of Brachial Plexus Injuries

ACOG has many different training and educational programs
for doctors and health care practitioners to help prevent
brachial plexus injuries. They routinely conduct clinical
seminars on the subject of 'Managing Shoulder Dystocia',
which help to educate doctors on the following topics:

- Is it possible to predict shoulder dystocia?

- Is it possible to prevent shoulder dystocia?

- When the emergency does occur, is it possible to resolve
shoulder dystocia without causing any fetal injury or
brachial plexus injuries?

- Is excess traction, applied by the doctor, the reason for
all brachial plexus injuries?

By taking part in such seminars and completing the training
courses, obstetricians and other health care givers are
then able to:

- Identify the various risk factors for shoulder dystocia
and take measures to prevent it if there is an increased
risk of dystocia.

- Resolve shoulder dystocia (if it occurs) in the best
possible manner using the various maneuvers for handling
dystocia.

- Understand why brachial plexus injuries occur, especially
due to the application of excessive traction. With better
understanding of these reasons there is higher chance of
resolving shoulder dystocia without brachial plexus
injuries.

ACOG also has videos on shoulder dystocia that show doctors
how to recognize the emergency in the labor room and how
they can help reposition mothers so as to widen their birth
canal to the maximum and help the baby to be delivered
without brachial plexus injuries such as Erb's palsy.

Thus, ACOG is doing its best to educate doctors about
shoulder dystocia, its prediction, and prevention. But
since shoulder dystocia and resultant brachial plexus
injuries are very difficult to predict, ACOG training for
doctors also aims to teach doctors how best to resolve
shoulder dystocia and prevent fetal injuries.

In addition to the above, ACOG seminars also aim to make
doctors aware about the many medico-legal aspects regarding
shoulder dystocia and brachial plexus injuries. Shoulder
dystocia lawsuits are discussed as well as the various
claims that can be made against doctors if fetal injuries
do occur. Since doctors are made aware of the huge
potential for expensive litigation in the form of brachial
plexus injury lawsuit, it does make them try that much
harder to prevent shoulder dystocia and conditions such as
Erb's palsy.

Information For Parents For Prevention Of Brachial Plexus
Injuries

Apart from training doctors and conducting clinical
seminars, ACOG is also involved in educating parents about
everything related to shoulder dystocia and brachial plexus
injuries. By providing relevant information to parents,
ACOG is trying to make them more aware of such birthing
emergencies and what parents can do to prevent fetal or
birth injuries to their babies.

ACOG routinely publishes practice bulletins with the latest
shoulder dystocia information for parents. The information
contained in these bulletins helps mothers to recognize
whether or not they are at an increased risk for shoulder
dystocia. If the risk of dystocia and brachial plexus
injuries is high, parents are advised as to the best way to
reduce such risk and ensure the birth of a healthy baby.

Two main risk factors for shoulder dystocia are maternal
diabetes and fetal macrosomia. ACOG has issued practice
bulletins on these two topics so that parents can manage
gestational diabetes properly and also perhaps opt for a
cesarean delivery if the fetus is macrosomic (excessively
large). Here are the ACOG guidelines on these two topics:

1. ACOG Guidelines For Fetal Macrosomia: The
recommendations are:

- Cesarean delivery is indicated when the weight of the
fetus is more than 4500 grams.

- Women who are not diabetic should consider cesarean
deliveries if the weight of their fetus is more than 5000
grams. For diabetic women the fetal weight for cesarean
consideration is 4500 grams.

2. ACOG Guidelines For Management Of Gestational Diabetes:
The recommendations are:

- Mothers should take the laboratory-screening test for
gestational diabetes between 24 and 28 weeks of pregnancy.

- If gestational diabetes is present, ask the obstetrician
about the best manner in which to manage this condition
during pregnancy.

ACOG also recommends that women who have gestational
diabetes and whose fetus weighs more than 4500 grams should
seriously consider a cesarean delivery as this reduces the
risk of brachial plexus injuries greatly.

The training programs, clinical seminars, and practice
bulletins issued by ACOG for parents and doctors thus go a
long way towards reducing the number of brachial plexus
injuries from shoulder dystocia.

----------------------------------------------------
Peter Kent maintains LegalView.com, your source for
everything legal. Anapol Schwartz, a member of
LegalView.com, has significant experience in aggressively
litigating birth injury and medical malpractice cases.
Their lawyers have won millions for clients injured by
their doctors' mistakes, including an $800,000 settlement
won by partner Alan Schwartz, Esq. the lawyer in this
shoulder dystocia case. For more information, go to
http://www.anapolschwartz.com/