Dimitrov A, Tsankova M, Nikolov A, Krŭsteva K, Kalaĭdzhieva M
Akush Ginekol (Sofiia). 2004;43(4):3-9.
The purpose of this retrospective study is to evaluate the perinatal outcome in cases with birth injuries, suggesting shoulder dystocia. This survey involves 92 cases of live newborns (gestational age between 37 and 42 weeks) with shoulder injuries. Another control group of 120 cases of live mature newborns without any shoulder injuries is studied for comparison. There are no significant differentialities between those two groups, regarding age, parity, weight and height of the parturients. Shoulder dystocia is most frequently found in newborns of 3500-4000 g birthweight. Antepartum, risk factors for shoulder dystocia are: diabetes, obesity of the mother and chronological postterm pregnancy. Intrapartum, the evaluated risk factors prove to be unreliable because the same were found in as many as one half of the non-traumatic vaginal deliveries. In 27% of the cases, shoulder dystocia occurs most probably after the passage of the shoulder through the pelvic inlet. The most frequent type of shoulder injury is fracture of the clavicle (90.2%), followed by paresis of the brachial plexus (7.6%). Severe shoulder dystocia both from obstetrical and neonatological point of view is found in 2-3% of the cases.
这项回顾性研究的目的是评估提示肩难产的分娩损伤病例的围产期结局。该调查涉及92例有肩部损伤的活产新生儿（胎龄在37至42周之间）。另选取120例无任何肩部损伤的足月活产新生儿作为对照组进行比较。两组产妇在年龄、产次、体重和身高方面无显著差异。肩难产最常见于出生体重3500 - 4000克的新生儿。产前，肩难产的危险因素有：糖尿病、母亲肥胖和过期妊娠。产时，所评估的危险因素被证明不可靠，因为在多达一半的非创伤性阴道分娩中也发现了这些因素。在27%的病例中，肩难产很可能发生在肩部通过骨盆入口之后。最常见的肩部损伤类型是锁骨骨折（90.2%），其次是臂丛神经麻痹（7.6%）。从产科和新生儿科角度来看，严重肩难产的病例占2 - 3%。
