Pre-natal:

• Prior macrosomia (large baby)
• Pre-existing diabetes
• Maternal weight (>180 lbs)
• Multiparity (a woman who has previously had a child)
• Prior gestational diabetes
• Short maternal stature
• Prior shoulder dystocia
• Advanced maternal age

Antepartum (pregnancy):

• Onset of gestational diabetes
• Excessive maternal weight gain (>35 lbs.)
• Postdatism (pregnancy continuing past 42 weeks)
• Macrosomia (large baby >4000grams i.e. 8.8 lbs)

Intrapartum (birth):

• Prolonged second stage (>2 hours)
• Protracted descent
• Failure of descent of head
• Abnormal first stage
• Need for mid-pelvic or assisted delivery
• Induction of labor
• Use of epidural
• Use of forceps or vacuum
• Improper delivery technique when shoulder dystoca is incurred (No use of the McRobert maneuver, Woods maneuver, suprapubic pressure ect.)

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