Fixed acupuncture points should be investigated, as well as the Eastern medical systems that are the foundation for acupuncture therapy. The report concludes that evidence for the potential value of acupuncture is strong enough to warrant further studies on its physiology and clinical value. The purpose of the document is to provide physicians with clinically useful information derived from a review of studies regarding the prediction, prevention and management of deliveries complicated by shoulder dystocia. According to ACOG, shoulder dystocia is an obstetric emergency that places both the woman and the fetus at risk of injury. The incidence of shoulder dystocia ranges from less than 1 percent to a little over 4 percent among vaginal cephalic deliveries.
Prevention is the best strategy in the management of shoulder dystocia.
If fetuses at risk of shoulder dystocia are identified early, elective cesarean delivery can be planned. However, identifying risk factors is not always possible. ACOG reports that macrosomia and maternal diabetes appear to be the two risk factors most often associated with shoulder dystocia. ACOG emphasizes that there is no accurate method for identifying which fetuses will have shoulder dystocia and that performing cesarean deliveries for all women suspected of carrying a macrosomic fetus is not appropriate. ACOG notes that injuries may occur to the fetus despite application of appropriate standard obstetric maneuvers.