Resuscitating the Baby after Shoulder Dystocia
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When shoulder dystocia takes five or more minutes to resolve, the neonate is likely to be depressed and need vigorous resuscitation.Two cases are presented in which severe shoulder dystocia was resolved within five minutes. Both babies were born without a heartbeat. Despite standard resuscitation by expert neonatologists, no heartbeat was obtained until volume resuscitation was started, at 25 minutes in the first case and 11 minutes in the second. After volume resuscitation circulation was restored, there was profound brain damage and the babies died.Unsuspected hypovolemic shock may explain some cases of failed resuscitation after shoulder dystocia. This may require a change in clinical practice. Rather than immediately clamping the cord after the baby is delivered, it is proposed that the obstetrician delay cord clamping to allow autotransfusion of the baby from the placenta and the neonatal resuscitators give volume much sooner....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4963557/
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