Overview
The purpose of this paper is to develop a review of a number of recent studies that attempts to explain and analyze the issues of prevention of the disease in depth. In particular, it will examine the growing volume of research data that is making it possible to understand the problem based on an evidence-based medicine (EMB) as the best approach.
Article reviews
Gittens-Williams LN. Delivery of the non-diabetic macrosomic infant. Towaco, NJ: Humana Press; 2009.
Introduction
The article developed a comprehensive analysis of shoulder dystocia, starting with an in-depth description of the condition. It also describes the difficulties facing the diagnosis and prediction and the consequences of failing to have a good detection method. According to the article, shoulder dystocia is a form of obstetric condition that is not only unpredictable, but also unpreventable.
Analysis
The authors state that the ability to predict the possibility of having the condition in a fetus is based on the statistical aspects of sensitivity and positive predictive value. For instance, the risk factors associated with the condition should be examined to determine whether they are able to identify the fetus that will have the problem at birth. For the positive predictive value, the issue is to determine the percentage of the mothers and their fetuses under the risk of developing and experiencing the condition. However, these statistical inferences have relatively low predictive values, which make it difficult to allow the practitioners to predict the occurrence of the condition with a good degree of accuracy.
Over the years, research studies that attempt to describe the sensitivity and predictive value of the condition have been lacking. However, there is a growing volume of research coming from recent studies that attempt to examine how the prediction of shoulder dystocia can be predicted and prevented.
Conclusion
The article concludes by highlighting the possibility of achieving good diagnostic and predictive methods for the condition. It states that although previous studies have not produced a universally accepted method of predicting the condition, it is important to develop a comprehensive understanding of the current trends in research studies that focus on prevention. In fact, it has been shown that the prevention of the condition can be effective even in cases where the predictive methods are not accurate enough.
O’Leary JA, Leonetti, HB. Shoulder dystocia: prevention and treatment. American journal of obstetrics and gynecology, 2010; 162: 5-9.
Introduction
The study by O’Leary and Leonetti (1990) is a qualitative and in-depth expert opinion analysis of the prevention and treatment of shoulder dystocia. The authors borrow heavily from various empirical studies that have attempted to focus on the issue of prevention and treatment of the problem. This makes the study fit into the EBM because it builds on the growing evidence-based information from research studies.
Analysis
In this article, the article states that the litigious environment that affects the clinical experts has made shoulder dystocia an important disease in the clinical field. The article argues that although there is no universally accepted method of predicting the occurrence of the disease, many cases of the condition are preventable based on the identification of multiple risk factors. For instance, glucose intolerance, obesity, macrosomal and postdate pregnancies in females are likely to reveal a possible occurrence of the problem in the foetuses.
Conclusion
The article contributes to the growing volume of knowledge about the shoulder dystocia by showing that a systematic treatment plan is adequate to describe or determine the severity of the problem. This means that efforts geared towards identifying the multiple risk factors are needed to treat the condition even in cases where the predictive values have low capacities of determining the occurrence accurately.
Maticot-Baptista, D., Collin, A., Martin, A., Maillet, R., & Riethmuller, D. (2007). [Prevention of shoulder dystocia by an ultrasound selection at the beginning of labour of foetuses with large abdominal circumference]. Journal de gynécologie, obstétrique et biologie de la reproduction, 36(1), 42-49
Introduction
The researchers used a prospective study based on clinical measurement of the foetal abdominal circumference of the mothers prior to delivery. The aim of the study was to determine the effectiveness of using an ultrasound screening at the beginning of labor in the prevention of shoulder dystocia.
Analysis
Some 170 mothers with macrosomial fetuses were identified at the la Mere et I’Enfat University Hospital in Besancon. The results of the quantitative study indicated that the patients with fetal abdominal circumference equal to or more than 350 mm had a 10% sensitivity of detecting the birth of newborns weighing 4250 g and above. Thus, the researchers concluded that measuring the AC is an effective method of predicting shoulder dystocia.
Conclusion
This study has increased information available for developing EBM. It contributes to the existing knowledge about the effective ways of predicting shoulder dystocia, which leads to the development of effective plans for treating and managing the condition during infancy.
O’leary, J. A. (2009). Shoulder dystocia and birth injury. New York: Humana Press.
Introduction
In this book, O’Leary (2009) develops an in-depth and well-informed expert opinion of shoulder dystocia in which he argues that the severity of the disease causes a similar increase in the need for additional ways of intervention.
Analysis
The author’s opinion is that delivering a posterior arm is the most important and safest technique for intervening during infancy shoulder dystocia. The author states that clinicians face a major problem in delivery rooms in various hospitals across the world due to increased cases of shoulder dystocia, yet the prediction of the condition remains underdeveloped. However, delivering of the posterior arm provides a remedy in delivering rooms due to its effectiveness in ensuring safe delivery. To justify this opinion, the author cites a number of previous studies that have attempted to confirm the need for the practice.
Conclusion
The article is an important source of information on research and EBM because it provides clinicians and nurses with a good analysis of the problems that normally face delivery rooms and a reliable way of ensuring safe and effective delivery using the posterior arm method
Øverland, E. A., Vatten, L. J., & Eskild, A. (2014). Pregnancy week at delivery and the risk of shoulder dystocia: a population study of 2,014,956 deliveries. BJOG, 121(3), 34
Introduction
In this study, the researchers attempt to determine whether late pregnancy at the end of the delivery, especially in the last week of the period, is a risk factor for the disease.
Analysis
Using a population-based design and a systematic review approach, the researchers considered all the normal deliveries (through vaginal canal) of single babies in Norway between 1967 and 2009. The total number of cases was over two million births, which was the study population. They calculated all the incidents of shoulder dystocia according to late pregnancy per every week. The analysis was carried several times for all the records.
The main measure of the study was the incidents of the disease at delivery during the last week of pregnancy. The results of the study indicate that less than 1% of the incidents were recorded throughout the period. However, the incidence of the condition increased during the last week of pregnancy. In addition, the researchers found a strong link between the weight at birth and the incidents of shoulder dystocia. Thus, it was concluded that the risk of developing the condition is positively associated with an increase in several aspects, including birth weight, maternal diabetes, labor induction as well as epidural analgesia during delivery.
Conclusion
The study is an important part of the growing volume of research required to address the problems associated with shoulder dystocia during delivery. In fact, the study is an empirical research carried out over a long period, which makes its results more valid than those carried out within a short period. As such, the study contributes significantly to the development and use of EBM.
Vidarsdottir H, Geirsson RT, Hardardottir H. (2011). Obstetric and neonatal risks among extremely macrosomic babies and their mothers. Am J Obstet Gynecol, 204:423.
Introduction
The objective of the study was to estimate the risk of complications during delivery of large infants, specifically those weighing 5000g and above.
Analysis
A cohort study was used to examine all the births of large babies recorded between 1996 and 2005. In addition, a comparison with normal births was made. The source of information was the national birth registration. The results of the study indicated that the risk of developing shoulder dystocia was relatively large in overweight infants. In addition, the mothers of such babies were at risk of being enrolled in emergency sections.
Conclusion
This study shows that overweight is a factor that shows a possible risk of developing the condition. It suggests that clinicians using EBM should consider advising pregnant mothers to seek medical help when the condition of the fetus shows evidence of being overweight.
References
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Safe prevention of the primary cesarean delivery. Obstetric Care Consensus No. 1. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;123: 693–711.
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Iffy L. Minimizing the risks of shoulder dystocia-related fetal injury. Towaco, NJ: Human Press; 2009.
Murray M, Huelsmann G. Labor and Delivery Nursing: Guide to Evidence-Based Practice. New York: Springer Publishing Company; 2011.
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