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Axillary traction: An effective method of resolving shoulder dystocia

BACKGROUND: At Counties Manukau Health in Auckland, New Zealand, axillary traction is being used when an internal manoeuvre is required for resolution of shoulder dystocia. AIMS: This study presents the outcomes for mother and baby from use of axillary traction and other internal manoeuvres. MATERIA...

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Autores principales: Ansell, Lesley, Ansell, David Alan, McAra‐Couper, Judith, Larmer, Peter John, Garrett, Nicholas Kenneth Gerald
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6851569/
https://www.ncbi.nlm.nih.gov/pubmed/31292947
http://dx.doi.org/10.1111/ajo.13029
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author Ansell, Lesley
Ansell, David Alan
McAra‐Couper, Judith
Larmer, Peter John
Garrett, Nicholas Kenneth Gerald
author_facet Ansell, Lesley
Ansell, David Alan
McAra‐Couper, Judith
Larmer, Peter John
Garrett, Nicholas Kenneth Gerald
author_sort Ansell, Lesley
collection PubMed
description BACKGROUND: At Counties Manukau Health in Auckland, New Zealand, axillary traction is being used when an internal manoeuvre is required for resolution of shoulder dystocia. AIMS: This study presents the outcomes for mother and baby from use of axillary traction and other internal manoeuvres. MATERIALS AND METHODS: Retrospective review of the clinical records of mother and baby for all labours complicated by shoulder dystocia was carried out for an eight‐year period. Maternal and neonatal information were compared for the three cohorts of the first internal manoeuvre documented: axillary traction, posterior arm delivery and rotational manoeuvres. RESULTS: There were 226 women who required the use of internal manoeuvres with no significant differences in age, body mass index, parity, ethnicity, diabetes incidence, induction and augmentation of labour rates, length of the first stage and birth weight between the cohorts. Axillary traction was the first internal manoeuvre used for 119 (52.7%) with a success rate of 95.8%. Posterior arm delivery was used first for 49 (21.7%) women with a success rate of 85.7%. Rotational manoeuvres were used first for 58 (25.7%) women with a statistically inferior success rate of 48.3%. There was no significant difference in the maternal and neonatal complication rates between the cohorts. CONCLUSION: Axillary traction has been utilised as the first internal manoeuvre for a large number of women with a higher success rate than other internal manoeuvres without any increase in maternal or neonatal morbidity. It is recommended that this be the first internal manoeuvre attempted when shoulder dystocia occurs.
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spelling pubmed-68515692019-11-18 Axillary traction: An effective method of resolving shoulder dystocia Ansell, Lesley Ansell, David Alan McAra‐Couper, Judith Larmer, Peter John Garrett, Nicholas Kenneth Gerald Aust N Z J Obstet Gynaecol Original Articles BACKGROUND: At Counties Manukau Health in Auckland, New Zealand, axillary traction is being used when an internal manoeuvre is required for resolution of shoulder dystocia. AIMS: This study presents the outcomes for mother and baby from use of axillary traction and other internal manoeuvres. MATERIALS AND METHODS: Retrospective review of the clinical records of mother and baby for all labours complicated by shoulder dystocia was carried out for an eight‐year period. Maternal and neonatal information were compared for the three cohorts of the first internal manoeuvre documented: axillary traction, posterior arm delivery and rotational manoeuvres. RESULTS: There were 226 women who required the use of internal manoeuvres with no significant differences in age, body mass index, parity, ethnicity, diabetes incidence, induction and augmentation of labour rates, length of the first stage and birth weight between the cohorts. Axillary traction was the first internal manoeuvre used for 119 (52.7%) with a success rate of 95.8%. Posterior arm delivery was used first for 49 (21.7%) women with a success rate of 85.7%. Rotational manoeuvres were used first for 58 (25.7%) women with a statistically inferior success rate of 48.3%. There was no significant difference in the maternal and neonatal complication rates between the cohorts. CONCLUSION: Axillary traction has been utilised as the first internal manoeuvre for a large number of women with a higher success rate than other internal manoeuvres without any increase in maternal or neonatal morbidity. It is recommended that this be the first internal manoeuvre attempted when shoulder dystocia occurs. John Wiley and Sons Inc. 2019-07-10 2019-10 /pmc/articles/PMC6851569/ /pubmed/31292947 http://dx.doi.org/10.1111/ajo.13029 Text en © 2019 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Ansell, Lesley
Ansell, David Alan
McAra‐Couper, Judith
Larmer, Peter John
Garrett, Nicholas Kenneth Gerald
Axillary traction: An effective method of resolving shoulder dystocia
title Axillary traction: An effective method of resolving shoulder dystocia
title_full Axillary traction: An effective method of resolving shoulder dystocia
title_fullStr Axillary traction: An effective method of resolving shoulder dystocia
title_full_unstemmed Axillary traction: An effective method of resolving shoulder dystocia
title_short Axillary traction: An effective method of resolving shoulder dystocia
title_sort axillary traction: an effective method of resolving shoulder dystocia
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6851569/
https://www.ncbi.nlm.nih.gov/pubmed/31292947
http://dx.doi.org/10.1111/ajo.13029
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