Johns Hopkins researchers, using a novel birthing simulator designed by biomedical engineering faculty, staff and students at the University, have identified what may be the least forceful way to deliver a baby whose shoulders are stuck in the birth canal.
Shoulder dystocia, in which the baby’s shoulders won’t move past the mother’s bony pelvis during delivery, occurs in about 5 percent of births. Of these, up to a quarter of deliveries may result in an injury to the baby’s brachial plexus, the nerves that control movement and sensation in the arm. As many as 10 percent of infants may sustain some permanent damage.
An obstetrician can perform one of several maneuvers to manipulate the position of either the mother or the baby when shoulder dystocia occurs. The Hopkins researchers found that turning the baby so its spine faces the mother’s belly (a technique known as anterior Rubin’s maneuver) requires less force than either turning the baby so its spine faces the mother’s spine, or moving the mother’s legs back to try to reduce the force of the baby’s shoulders against the mother’s pelvis.
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