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Open Medicine

formerly Central European Journal of Medicine

Editor-in-Chief: Darzynkiewicz, Zbigniew

IMPACT FACTOR 2018: 1.221

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Volume 4, Issue 1


Volume 10 (2015)

Shoulder dystocia related fetal neurological injuries: the role of diabetic control

Leslie Iffy
  • Departments of Obstetrics & Gynecology, University of Medicine and Dentistry of New Jersey, 07103, Newark, New Jersey, USA
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/ Michael Brimacombe / Valeria Varadi / Maya Raghuwanshi / Vijaya Ganesh
  • Departments of Obstetrics & Gynecology, University of Medicine and Dentistry of New Jersey, 07103, Newark, New Jersey, USA
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/ Vijaya Raju
  • Departments of Obstetrics & Gynecology, University of Medicine and Dentistry of New Jersey, 07103, Newark, New Jersey, USA
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Published Online: 2009-02-11 | DOI: https://doi.org/10.2478/s11536-008-0086-y


The study explores the roles of routine prenatal diabetic screening and control in the occurrence of neurological birth injuries associated with shoulder dystocia. The investigation involved retrospective review of 226 medical records that contained information about the antenatal events in cases that resulted in permanent neonatal injuries following arrest of the shoulders at delivery. Close attention was paid to diabetic screening and management of mothers with evidence of glucose intolerance. Analysis of the records revealed that one-third of all women, including those with predisposing factors, received no diabetic screening during pregnancy. The majority of confirmed diabetic patients were not treated adequately. Among babies of diabetic women, birth weights exceeding 4500 g were about 30-fold more frequent than among those with normal glucose tolerance. The data suggest that universal screening and rigid diabetic control, including mothers with borderline glucose tolerance, are effective measures for the prevention of excessive fetal growth and intrapartum complications deriving from it. If ignored, impaired maternal glucose tolerance may become a major predisposing factor for neurological birth injuries. It appears therefore that with routine screening for diabetic predisposition and effective control of gestational diabetes the risk of fetal damage can be reduced substantially.

Keywords: Diabetes; Diabetic screening; Shoulder dystocia; Brachial plexus injury; Erb’s palsy

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About the article

Published Online: 2009-02-11

Published in Print: 2009-03-01

Citation Information: Open Medicine, Volume 4, Issue 1, Pages 76–83, ISSN (Online) 2391-5463, DOI: https://doi.org/10.2478/s11536-008-0086-y.

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© 2009 Versita Warsaw. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. BY-NC-ND 3.0

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