A belief that prolonged head-to-body delivery interval endangers the newborn underpins the common obstetrical practice of delivering the baby’s trunk immediately after the head is born. Without intervention, however, birth typically occurs in two steps: once the fetal head is delivered there is usually a pause, and the rest of the infant is born with the next contraction. Dr. Kotaska will discuss evidence showing that a two-step delivery does not increase the risk of fetal harm, may lower the incidence of shoulder dystocia, and should be considered physiologically normal, with implications for the definition of shoulder dystocia.
Learning Objectives:
Objective 1: Describe the physiological mechanism of birth of the fetal trunk;
Objective 2: Explain the mechanics and hemodynamics of shoulder dystocia;
Objective 3: Explain the acid-base physiology of neonatal hypoxic encephalopathy caused by shoulder dystocia; and
Objective 4: Incorporate physiological two-step delivery into a definition of shoulder dystocia.
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