Shoulder Dystocia< b>Am J Obstet Gynecol. 1997 Aug;177(2):463-4.
Catastrophic shoulder dystocia and emergency symphysiotomy.
Goodwin TM, Banks E, Millar LK, Phelan JP.
Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA.
We present three cases of shoulder dystocia unrelieved by standard maneuvers, including cephalic replacement. Symphysiotomy was performed in an effort to preserve fetal life. All three infants sustained severe neurologic injury and later died. Maternal morbidity including urinary incontinence was significant but responded to treatment. Symphysiotomy may be the only method of relieving some cases of shoulder dystocia, but its role remains unclear because of operator inexperience and maternal morbidity.