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

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.

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