肩难产(sln,ulder dystocia)是产科的严重并发症。其发生率虽然不高,但由于较难预测,往往猝然发生导致措手不及。处理不当会导致新生儿臂丛神经麻痹、锁骨及上肢骨折、胸锁乳突肌撕裂、颅内出血、死产等严重后果。1肩难产的定义及发病率:传统的肩难产定义为胎头娩出后胎儿前肩嵌顿于耻骨联合下方,用常规助产手法不能娩出胎儿双肩称为肩难产。很多学者及研究人员对其作了更具体的描述。1986年Resnile在上述定义的基础上将其描述为胎头娩出后除向下牵引和会阴切开之外,还需其他手法娩出胎肩者称为肩难产。1995年Spong等[1]观察了250例分娩,并详细记录了胎头娩出到胎体娩出的时间,建议以胎头至胎体 Shoulder labor (sln, ulder dystocia) is a serious complication of obstetrics. Although the incidence is not high, but because of the more difficult to predict, often happen suddenly led to by surprise. Improper handling can lead to neonatal brachial plexus paralysis, clavicle and upper limb fractures, sternocleidomastoid tear, intracranial hemorrhage, stillbirth and other serious consequences. 1 Definition and incidence of shoulder dystocia: Traditional shoulder dystocia is defined as the fetus after the fetus was implanted in the front pubic incarcerated under the pubic symphysis, with conventional midwifery techniques can not be delivered fetal shoulders called shoulder dystocia. Many scholars and researchers made a more specific description of it. Resnile in 1986 on the basis of the above definition described as the fetal head after delivery in addition to downward traction and perineal incision, the need for other means of delivery shoulder is called shoulder dystocia. 1995 Spong et al [1] observed 250 cases of childbirth, and a detailed record of the fetal head delivered to the carcass was delivered time, it is recommended to the fetal head to the carcass