Improving Risk Assessment of Shoulder Dystocia - CALM Shoulder Screen™

Did you know?

• Shoulder dystocia with neonatal injury occurs in about 0.4 to 3 vaginal births per 1000;
• Short mothers, maternal obesity and large babies are the principal risk factors;
• Rates of maternal obesity (a risk factor) are increasing;
• Medical liability payouts for a baby with subsequent disability average around $500,000.

• Development of the CALM Shoulder Screen Program
  This presentation will demonstrate how “SD” is “unpredictable” based on birth weight guidelines and how “SD with brachial plexus injury” differs from this based on advanced statistical methods.  
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• Practical Application of the CALM Shoulder Screen Program
  This presentation will provide an overview of software which is designed to lessen medico-legal vulnerability and avoid injury associated to Shoulder Dystocia as well as provide practical application tips for the use of CALM Shoulder Screen in the office, clinics and hospital settings.
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• Tutorial of the CALM Shoulder Screen Computer Application
  This presentation is a complete tour of the web-based CALM Shoulder Screen application. Learn how to access the system, enter patient information, run a screen and print risk results. Perfect for new users as well as those in need of a �how-to� refresher.
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The Main Issues

Existing guidelines recommend consideration of elective cesarean when estimated fetal weight is greater than 5000g, or over 4500g in the presence of maternal diabetes.

The average fetal weight of babies experiencing shoulder dystocia with injury is around 4000g.

The CALM Shoulder Screen™ Program

Now physicians can assess the risk of shoulder dystocia on behalf of their patients.

• Before the onset of labor;
• Using easily available measures;
• Providing a good balance between sensitivity and false positives.

CALM Shoulder Screen (patent pending) is a program to assess the risk of shoulder dystocia with injury. The algorithm is based on anthropometric maternal and fetal characteristics. Depending upon preferred thresholds, its detection rates between 30% and 61% could translate to multi-million dollar savings for large hospital systems or insurers.

Key Benefits

• Assesses risk of shoulder dystocia with injury at or before the onset of labor;
• Uses easily available measures;
• Greatly improves detection rate with a relatively small increase in the rate of cesarean;
• Enables clinical teams to communicate risk effectively to patients when recommending a course of action;
• Provides institutions with the ability to select appropriate thresholds for their respective practices.

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View of patient's assessment for risk of Shoulder Dystocia.

Key Features

• Risk assessment can be performed from 36 weeks of gestation onward;
• Web based;
• HIPAA compliant;
• Accessible from the physician's office or from the hospital;
• Easy to use, print and save;
• Builds individual or institutional database;
• Provides links to useful information;

Applications

• Prospectively
• Retrospectively in quality review

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