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Axillary traction: An effective method of resolving shoulder dystocia
Author(s) -
Ansell Lesley,
Ansell David Alan,
McAraCouper Judith,
Larmer Peter John,
Garrett Nicholas Kenneth Gerald
Publication year - 2019
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.13029
Subject(s) - medicine , shoulder dystocia , traction (geology) , obstetrics , pregnancy , surgery , genetics , geomorphology , biology , geology
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.