What complication is a postpartum woman at increased risk for due to shoulder dystocia?

Shoulder dystocia poses unique challenges during childbirth, particularly concerning potential complications that may arise in the postpartum period. One key risk associated with shoulder dystocia is hemorrhage. This occurs due to various factors that affect the tone and contractility of the uterus after delivery.

In instances of shoulder dystocia, the mechanism of labor may involve significant manipulation, which can lead to uterine atony—where the uterus fails to contract effectively after birth. Atony is a leading cause of primary postpartum hemorrhage because a well-contracted uterus is essential for compressing the blood vessels that previously supplied the placenta and controlling bleeding. Moreover, if significant trauma occurs (such as lacerations or hematomas during delivery), this can further increase the likelihood of hemorrhage.

Furthermore, the stress and potential injury to the pelvic muscles and retroperitoneal structures can exacerbate bleeding challenges. Therefore, a woman who experiences shoulder dystocia is more susceptible to postpartum hemorrhage, underlining the importance of careful monitoring and management of uterine tone and potential lacerations in the aftermath of such an event.