Re: [ozmidwifery] question

[JoFromOz]

Susan Cudlipp wrote: Good point Anne!   I did quite a thorough search last night and have printed off some good articles which I will pass on.  However I could not find the answer to why EXACTLY babies die in shoulder dystocia.  If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them. The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?)  per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP.  (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord, would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck.  Any answers on that one? Thanks Sue   >From what I remember being taught, the reason SD causes such a problem is because the chest is compressed, and the heart cannon function properly.  I can't see the cord being a problem, as if the shoulder(s) are behind the symphysis pubis, then the cord would be further into the uterus, and therefore protected - unless there is a nuchal cord? Jo