Hartiasynnytys

Hartiasynnytys, also known as shoulder dystocia, is a childbirth complication that occurs when one or both of the baby's shoulders become stuck in the mother's pelvis after the head has been delivered. This condition is a medical emergency that requires prompt intervention to prevent harm to both the baby and the mother.

The most common cause of shoulder dystocia is when the baby's shoulders are wider than its head, or when the baby is particularly large. Other contributing factors can include maternal diabetes, obesity, a prolonged second stage of labor, or the use of forceps or vacuum extraction during delivery.

When shoulder dystocia occurs, the baby's head may emerge but then retract against the mother's perineum, a sign often referred to as the "turtle sign." This indicates that the shoulders are caught.

Immediate management involves various maneuvers performed by the medical team to free the baby's shoulders. These can include specific maternal positioning changes, such as the McRoberts maneuver or the delivery of the posterior arm. If these initial steps are unsuccessful, more advanced techniques may be employed.

The risks associated with shoulder dystocia are significant. For the baby, potential complications include brachial plexus injuries, fractures of the clavicle or humerus, and in rare cases, oxygen deprivation leading to brain damage or death. For the mother, risks include postpartum hemorrhage and perineal tears.

Prevention strategies focus on identifying risk factors during pregnancy and labor. Close monitoring of labor progress and careful consideration of delivery methods are crucial. While not all cases of shoulder dystocia can be predicted or prevented, prompt recognition and skillful management are essential for a positive outcome.