Refractory shoulder dystocia in term macrosomic newborn with verified complete meningoencephalomyelocele

• Authors: Dubravko Habek , Gordana Horvat , Tomislav Kulaš , Ivanka Janiška , Milan Stanojević , Renato Bauman , Tomislav Hafner
• Languages of publication: EN

Abstracts

EN

The authors presented the birth course, in a primiparous woman with complicated, refractory, high shoulder dystocia, of a macrosomic term-born malformed child (4400/54) with complete occipital meningoencephalomyelocele and microcephaly. After head delivery, high shoulder dystocia occurred that could not be resolved with neither the McRoberts or Resnik maneuver nor with the Woods and Barnum maneuvers, despite recurred tries. Only on third attempt with the Barnum maneuver was the posterior arm released with hand traction, followed by the whole body of the macrosomic baby. The child was transferred to the Neurosurgery department where operative correction was performed, and after the intervention the child died because of respiratory insufficiency. Due to the strict parental decision on pregnancy continuation and prohibition of any obstetric interventions during delivery, unborn child and parturient, as well as the obstetric team, were put into high professional, forensic and ethical risk.

Keywords

EN

Shoulder dystocia; Maneuvers; Meningoencephalomyelocele; Fetal macrosomia; Risk

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2008
• Volume: 3
• Issue: 1
• Pages: 115-117

Dates

published

1 - 3 - 2008

online

1 - 3 - 2008

Contributors

author

Dubravko Habek

• Department of Obstetrics and Gynecology, School of Medicine, Zagreb University, Sveti Duh Hospital Zagreb, Croatia

author

Gordana Horvat

• Department of Obstetrics and Gynecology, School of Medicine, Zagreb University, Sveti Duh Hospital Zagreb, Croatia

author

Tomislav Kulaš

• Department of Obstetrics and Gynecology, School of Medicine, Zagreb University, Sveti Duh Hospital Zagreb, Croatia

author

Ivanka Janiška

• Department of Obstetrics and Gynecology, School of Medicine, Zagreb University, Sveti Duh Hospital Zagreb, Croatia

author

Milan Stanojević

• Department of Obstetrics and Gynecology, School of Medicine, Zagreb University, Sveti Duh Hospital Zagreb, Croatia

author

Renato Bauman

• Department of Obstetrics and Gynecology, School of Medicine, Zagreb University, Sveti Duh Hospital Zagreb, Croatia

author

Tomislav Hafner

• Department of Obstetrics and Gynecology, School of Medicine, Zagreb University, Sveti Duh Hospital Zagreb, Croatia

References

• [1] Habek D. Fetal shoulder dystocia. Acta. Med. Croat., 2002, 56, 57–63
• [2] Gross T., Sokol R., Williams T., Thompsen K., Shoulder dystocia: A fetal-physician risk., Am. J. Obstet. Gynecol., 1987, 156, 1408–1418 [Crossref]
• [3] Gherman R., Catastrophic shoulder dystociawhat is the etiology?, Am. J. Obstet. Gynecol., 1998, 178, 417–418 http://dx.doi.org/10.1016/S0002-9378(98)80039-2[Crossref]
• [4] Baskett T.F., Allen A.C., Perinatal implications of shoulder dystocia., Obstet. Gynecol., 1995, 86, 14–17 http://dx.doi.org/10.1016/0029-7844(95)00099-D[Crossref]
• [5] Pooh R.K., Maeda K., Pooh K.H., Kurjak A., Sonographic assessment of the fetal brain morphology., Prenat. Neonat. Med., 1999, 4, 18–38
• [6] Mealey J., Ozenitis A.J., Hockeley A.A., The prognosis of encephaloceles., J. Neurosurg., 1970, 32, 209–211 http://dx.doi.org/10.3171/jns.1970.32.2.0209[Crossref]
• [7] Chervenak F.A., Isaacson G., Mahoney M.J., Diagnosis and management of fetal cephalocele. Obstet. Gynecol., 1984, 64, 86–91 [PubMed]
• [8] Fitz C.R., Midline anomalies of the brain and spine., Radiol. Clin. North. Am., 1982, 20, 95–100 [PubMed]
• [9] Mazouni C., Porcu G., Cohen-Solal E., Heckenroth H., Guidicelli B, Bonnier P, et al., Maternal and anthropomorphic risk factors for shoulder dystocia., Acta. Obstet. Gynecol. Scand., 2006, 8, 567–570 http://dx.doi.org/10.1080/00016340600605044[Crossref]
• [10] Noble A., Brachial plexus injuries and shoulder dystocia: medico-legal commentary and implications., J. Obstet. Gynaecol., 2005, 25, 105–107 http://dx.doi.org/10.1080/01443610500051338[Crossref]
• [11] Geary M., McParland P., Johnson H., Stronge J. Shoulder dystocia-is it predictable?, Eur. J. Obstet. Gynecol. Reprod. Biol., 1995, 65, 15–18 http://dx.doi.org/10.1016/0301-2115(95)02160-9[Crossref]
• [12] Habek D., Forensic aspects of the shoulder dystocia. In: Habek D. (Ed.): Forensic gynecology and obstetrics. Publisher Gradska tiskara Osijek, 2003, 118–128

Identifiers

DOI

10.2478/s11536-007-0052-0