Risk Factors


  • 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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