The problem of shoulder dystocia

Shoulder dystocia occurs in 1 in 300 deliveries. It carries a high incidence of poor outcomes, particularly brachial plexus injury to the fetus. As well as fetal and maternal morbidity, suboptimal management leaves the NHS at major risk of litigation. Single risk factors are of little value in predicting shoulder dystocia, but consideration of the combinations of risk factors may help to avoid some cases. The manoeuvres used to cope with shoulder dystocia are well known and must be regularly rehearsed to familiarise staff with them. Careful attention to practice and documentation will reduce the litigation risk.