Resuscitating the Baby after Shoulder Dystocia

Background. To propose hypovolemic shock as a possible explanation for the failure to resuscitate some babies after shoulder dystocia and to suggest a change in clinical practice. Case Presentation. Two cases are presented in which severe shoulder dystocia was resolved within five minutes. Both babi...

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Main Authors: Savas Menticoglou, Carol Schneider
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/2016/8674167
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author Savas Menticoglou
Carol Schneider
author_facet Savas Menticoglou
Carol Schneider
author_sort Savas Menticoglou
collection DOAJ
description Background. To propose hypovolemic shock as a possible explanation for the failure to resuscitate some babies after shoulder dystocia and to suggest a change in clinical practice. Case Presentation. Two cases are presented in which severe shoulder dystocia was resolved within five minutes. Both babies were born without a heartbeat. Despite standard resuscitation by expert neonatologists, no heartbeat was obtained until volume resuscitation was started, at 25 minutes in the first case and 11 minutes in the second. After volume resuscitation circulation was restored, there was profound brain damage and the babies died. Conclusion. Unsuspected hypovolemic shock may explain some cases of failed resuscitation after shoulder dystocia. This may require a change in clinical practice. Rather than immediately clamping the cord after the baby is delivered, it is proposed that (1) the obstetrician delay cord clamping to allow autotransfusion of the baby from the placenta and (2) the neonatal resuscitators give volume much sooner.
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spelling doaj-art-16ab59d9c61341ae8eb67ddb6e8af0302025-08-20T02:02:37ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922016-01-01201610.1155/2016/86741678674167Resuscitating the Baby after Shoulder DystociaSavas Menticoglou0Carol Schneider1Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, WR125-735 Notre Dame Avenue, Winnipeg, MB, R3E 0L8, CanadaDivision of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, WR125-735 Notre Dame Avenue, Winnipeg, MB, R3E 0L8, CanadaBackground. To propose hypovolemic shock as a possible explanation for the failure to resuscitate some babies after shoulder dystocia and to suggest a change in clinical practice. Case Presentation. Two cases are presented in which severe shoulder dystocia was resolved within five minutes. Both babies were born without a heartbeat. Despite standard resuscitation by expert neonatologists, no heartbeat was obtained until volume resuscitation was started, at 25 minutes in the first case and 11 minutes in the second. After volume resuscitation circulation was restored, there was profound brain damage and the babies died. Conclusion. Unsuspected hypovolemic shock may explain some cases of failed resuscitation after shoulder dystocia. This may require a change in clinical practice. Rather than immediately clamping the cord after the baby is delivered, it is proposed that (1) the obstetrician delay cord clamping to allow autotransfusion of the baby from the placenta and (2) the neonatal resuscitators give volume much sooner.http://dx.doi.org/10.1155/2016/8674167
spellingShingle Savas Menticoglou
Carol Schneider
Resuscitating the Baby after Shoulder Dystocia
Case Reports in Obstetrics and Gynecology
title Resuscitating the Baby after Shoulder Dystocia
title_full Resuscitating the Baby after Shoulder Dystocia
title_fullStr Resuscitating the Baby after Shoulder Dystocia
title_full_unstemmed Resuscitating the Baby after Shoulder Dystocia
title_short Resuscitating the Baby after Shoulder Dystocia
title_sort resuscitating the baby after shoulder dystocia
url http://dx.doi.org/10.1155/2016/8674167
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AT carolschneider resuscitatingthebabyaftershoulderdystocia