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One of the most pressing risks that medical professionals must account for during the birthing process is the possibility of one or both of the baby’s shoulders getting caught on the mother’s pelvic bone, effectively preventing full delivery.
This birthing scenario, known as shoulder dystocia, not only puts the baby at risk of fractures or even suffocation, but also of developing significant nerve damage.
As you might imagine, the risk of shoulder dystocia becomes all the more acute for those women giving birth to exceptionally large children. Indeed, the American Congress of Obstetricians and Gynecologists has determined that while shoulder dystocia occurs naturally in roughly 1 percent of all births involving normal weight babies, this number jumps to 10 percent for all births involving oversized babies.
In recognition of this reality, a group of European researchers recently set out to determine whether inducing labor before oversized babies are full term — meaning while they are smaller — would reduce the rates of shoulder dystocia.
Using sonograms, the researchers identified more than 800 women/volunteers whose babies could be considered oversized (i.e., they were in the 95th percentile for weight according to their gestational age).
From there, these volunteers were randomly divided into two groups: one group that would be induced at 37-38 weeks instead of the full-term 39 weeks, and another that would be monitored until they went into labor naturally or induction became medically necessary.
After examining the ultimate birth numbers, the researchers determined that shoulder dystocia occurred in just two percent of the births in the induction group as compared with six percent in the monitored group. Breaking the numbers down further, the researchers found that for every 25 inductions at least one case of shoulder dystocia was prevented.
The medical community has neither rejected nor embraced the study findings. Indeed, many professionals have indicated that the study highlights how patients and clinicians may need to start having careful consultations when oversized babies are involved, discussing among other things the risk of neonatal complications that accompanies early induction and the risk of shoulder dystocia that accompanies full-term births.
What are your thoughts on this fascinating study?