Shoulder presentation

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Prab R. Tumpati, MD — Editor-in-Chief, WikiMD Medical Encyclopedia
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Shoulder presentation
Synonyms
Pronounce	N/A
Specialty	N/A
Symptoms	Abnormal fetal position
Complications	Obstructed labor, fetal distress
Onset
Duration
Types
Causes	Multiple pregnancy, polyhydramnios, uterine abnormalities
Risks
Diagnosis	Ultrasound, physical examination
Differential diagnosis	Breech presentation, cephalic presentation
Prevention
Treatment	Cesarean section, external cephalic version
Medication
Prognosis
Frequency	Rare
Deaths	N/A

Shoulder presentation is a type of malpresentation in which the fetus is positioned with its shoulder pointing towards the birth canal. This condition is a form of transverse lie, where the fetus lies horizontally in the uterus rather than the typical cephalic presentation (head-first) or breech presentation (buttocks or feet first).

Causes

Shoulder presentation can be caused by several factors, including:

• Multiple pregnancy (twins or more)
• Polyhydramnios (excessive amniotic fluid)
• Uterine abnormalities such as fibroids or congenital malformations
• Placenta previa, where the placenta covers the cervix
• Premature labor, where the fetus has not yet assumed the head-down position

Diagnosis

Shoulder presentation is typically diagnosed through:

• Physical examination: The healthcare provider may feel the shoulder during a pelvic exam.
• Ultrasound: Imaging can confirm the position of the fetus.
• Leopold's maneuvers: A series of abdominal palpations to determine fetal position.

Complications

Shoulder presentation can lead to several complications, including:

• Obstructed labor
• Increased risk of cesarean section
• Umbilical cord prolapse
• Fetal distress

Management

Management of shoulder presentation may involve:

• Attempting an external cephalic version (ECV) to turn the fetus to a head-down position.
• Planning for a cesarean section if the fetus cannot be repositioned.
• Close monitoring of the pregnancy to manage any arising complications.

See also

• Cephalic presentation
• Breech presentation
• Transverse lie
• External cephalic version
• Cesarean section

External links

This obstetrics related article is a stub.