Zusammenfassung
Die Schulterdystokie ist die Hauptursache für geburtsassoziierte Plexusparesen. Etwa 10–15 % der Schulterdystokien sind mit einer Plexusparese assoziiert. Wichtigster Risikofaktor für die Schulterdystokie ist die fetale Makrosomie. Ein mütterlicher Diabetes mellitus führt gehäuft zu einer fetalen Makrosomie und stellt darüber hinaus ein eigenständiges Risiko für eine Schulterdystokie dar. Darüber hinaus sind vaginal-operative Entbindungen mittels Forzeps oder Vakuumextraktion gehäuft mit Schulterdystokien assoziiert. Für den Geburtshelfer gilt es, vor der Geburt sorgfältig abzuschätzen, ob ein erhöhtes Risiko für eine Schulterdystokie besteht. Ist dies der Fall, muss die Schwangere ggf. über die Entbindungsalternative eines Kaiserschnitts aufgeklärt werden. Zur Prävention einer Plexusparese ist die Schulung der Geburtshelfer – Ärzte und Hebammen – entscheidend, weil dann viele Fälle einer Schulterdystokie überwunden werden können, ohne dass es zu einer bleibenden Plexusparese kommt.
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Schwenzer, T. (2017). Geburtshilfliche Risikofaktoren. In: Bahm, J. (eds) Bewegungsstörungen der oberen Extremität bei Kindern. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-50426-0_3
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