肩难产之后：处理后续的妊娠与分娩
After shoulder dystocia: managing the subsequent pregnancy and delivery.
作者信息
Gurewitsch Edith D, Johnson Tara L, Allen Robert H
机构信息
Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
出版信息
Semin Perinatol. 2007 Jun;31(3):185-95. doi: 10.1053/j.semperi.2007.03.009.
Among risk factors for shoulder dystocia, a prior history of delivery complicated by shoulder dystocia is the single greatest risk factor for shoulder dystocia occurrence, with odds ratios 7 to 10 times that of the general population. Recurrence rates have been reported to be as high as 16%. Whereas prevention of shoulder dystocia in the general population is neither feasible nor cost-effective, intervention efforts directed at the particular subgroup of women with a prior history of shoulder dystocia can concentrate on potentially modifiable risk factors and individualized management strategies that can minimize recurrence and the associated significant morbidities and mortality.
在肩难产的危险因素中，既往分娩有肩难产并发症是肩难产发生的单一最大危险因素，其优势比是普通人群的7至10倍。据报道复发率高达16%。虽然在普通人群中预防肩难产既不可行也不具有成本效益，但针对有肩难产既往史这一特定亚组女性的干预措施可以集中在潜在可改变的危险因素以及可将复发率和相关严重发病率及死亡率降至最低的个体化管理策略上。
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