The population of gravidas delivering large infants (4000+ g) was examined to determine if the labor pattern and delivery method might serve as clinical indicators of shoulder dystocia. Although any given patient could only have experienced either a normal labor pattern or an abnormal labor pattern, some of those who experienced an abnormal labor pattern had more than one type of labor abnormality. Therefore, the total number of labor abnormalities can be expected to be greater than the total number of patients.
There were 272 diabetic gravidas delivered vaginally and abdominally during the interval of this study. Of the 67 (24.2%) whose infant’s birth weight was 4000+ g, 31 (46.3%) were delivered by cesarean section. Shoulder dystocia occurred in 11 (30.6%) of 36 women delivered vaginally. Of 31 spontaneous deliveries, nine (29.0%) were complicated by shoulder dystocia (Table 3). Similarly, six of 25 (24.0%) with normal labor and three of four (75.0%) with precipitate labor were complicated by shoulder dystocia.