Page 32 - OB Risks - Delivering the Goods (Part Two)

SVMIC Obstetrics Risks: Delivering the Goods

Document all interpretations, interventions, plans of care, and
patient informed consent discussions carefully and thoroughly

in the medical record. Include signed informed consent
forms. Complete, specific, and documented informed consent

discussions are invaluable to a defense.

If it is determined during prenatal care that the patient may

be at risk of shoulder dystocia, the patient’s labor progression
should be followed closely for indications of difficulty. As always,

it is essential that the physician accurately document the
management of labor and any delivery complications.

Risk factors for a potential shoulder dystocia may include

induction of labor, epidural anesthesia, prolonged second
stage labor, and operative vaginal delivery. If the obstetrician
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suspects the baby is heavier than normal, and the patient’s labor
is not progressing normally, the obstetrician should be ready for

an impending shoulder dystocia. A protracted active phase of
labor, secondary arrest of labor, or prolonged second stage of

labor should be interpreted as signs of an abnormal labor.
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In the event of an injury to the infant, review the delivery with

the patient, including the previously known risks for shoulder
dystocia, the sequence of events at delivery, the actions that

were taken during the delivery, and why the actions were
taken. Document the review in the medical record. If the infant

is requiring more assistance than usual, consider consulting
the infant’s attending physician as to the infant’s status and

54 https://www.researchgate.net/publication/51798202_Critical_analysis_of_risk_factors_for_
shoulder_dystocia
55 Id.

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