Can shoulder dystocia and brachial plexus injury be prevented?
Up until this point we have been looking for various ways of predicting which babies and which labors will experience shoulder dystocia and possible brachial plexus injury. But such predictions, even if they can be made, are useless if there is no way to alter labor and delivery management so as to prevent shoulder dystocia and brachial plexus injury from occurring. Thus a most important question is this: Given what we know about shoulder dystocia and brachial plexus injury, is there anyway to prevent them? As with the question of the predictability of shoulder dystocia, the answer to the question as to whether or not shoulder dystocia can be prevented has changed with the work of Gudmundsoon (2005) and Mazouni (2006) linking maternal size and fetal weight with shoulder dystocia and with the development of Hamiltons shoulder dystocia risk predictive tool. Certainly if 50% or more of shoulder dystocias can be accurately predicted with a low false positive rate (2.7%), then prophylactic
