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Shoulder dystocia occurs after vaginal delivery of the head, when the baby's anterior shoulder is obstructed by the mother's pubic bone. [3] [1] It is typically diagnosed when the baby's shoulders fails to deliver despite gentle downward traction on the baby's head, requiring the need of special techniques to safely deliver the baby. [2]
Obstetric injuries may occur from mechanical injury involving shoulder dystocia during difficult childbirth, [5] with a prevalence of 1 in 1000 births. [6] "The brachial plexus may be injured by falls from a height on to the side of the head and shoulder, whereby the nerves of the plexus are violently stretched.
Erb's palsy is a paralysis of the arm caused by injury to the upper group of the arm's main nerves, specifically the severing of the upper trunk C5–C6 nerves. These form part of the brachial plexus, comprising the ventral rami of spinal nerves C5–C8 and thoracic nerve T1.
Shoulder presentations are uncommon (about 0.5% of births) [1] since, usually, toward the end of gestation, either the head or the buttocks start to enter the upper part of the pelvis, anchoring the fetus in a longitudinal lie. It is not known in all cases of shoulder presentation why the longitudinal line is not reached, but possible causes ...
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Specific situations that can contribute to birth injury include breech presentation and shoulder dystocia. Most fetal birth injuries resolve without long term harm, but brachial plexus injury may lead to Erb's palsy or Klumpke's paralysis .
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