Shoulder Presentation - Frequency and Causes

Frequency and Causes

Shoulder presentations are uncommon (about 0.5% of births) as usually towards the end of gestation either the head or the buttocks start to enter the upper part of the pelvis anchoring the fetus in a longitudinal lie. It is not known in all cases of shoulder presentation why the longitudinal lie is not reached, but possible causes include bony abnormalities of the pelvis, uterine abnormalities such as malformations or tumors (fibroids), and other tumors in the pelvis or abdomen can also lead to a shoulder presentation. Other factors are a lax abdominal musculature, uterine overdistension (i.e. polyhydramnios), multiple gestation, placenta previa, a small fetus, or a fetus with some abnormality. Further, if the amniotic fluid sac ruptures the shoulder or arm may become wedged as a shoulder presentation.

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