Gynecology & Obstetrics
Open Access

Abstract

Association between Shoulder Dystocia Maneuvers and Cervical Laceration Requiring Repair

Reinou S Groen, Stephanie McKenney, Irina Burd, Janyne E Althaus and Cynthia H Argani

Objective: To determine if there is an association between shoulder dystocia maneuvers (SDM) and cervical laceration requiring repair (CLRR).

Study design: Retrospective cohort study in a single university-affiliated community hospital for term singleton vertex vaginal deliveries from 7/1/05-7/24/13. Data were analyzed by two-tailed exact mid-p test and risk ratio.

Results: A total of 391 from 7,153 (5.5%) term singleton vertex vaginal deliveries required SDM. A total of 27 (0.38%) cervical lacerations were identified, 22 (81%) of which were repaired. Four of 391 patients (1.0%) with SDM had CLRR compared to 18 of 6,757 patients (0.3%) without SDM (p=0.035). The RR for CLRR with SDM was 3.84 (95% CI:1.3-11.5). There was no statistical difference (p=0.36) in delivery of the posterior arm with the incidence of cervical laceration requiring repair.

Conclusion: SDM were significantly associated with CLRR. Cervical laceration may be an infrequent, but unavoidable consequence of SDM; however, this association may also reflect common risk factors between shoulder dystocia and cervical laceration.