Neglected shoulders reported at the Befelatanana Maternity Hospital Antananarivo, Madagascar

We conducted a retrospective study on neglected shoulders during 12 months at the Maternity Hospital of Befelatanana, 31 cases among 4685 deliveries were reported. The majority of the pregnancies are not under medical supervision and no ultrasound is carried out during the third trimester. There were 8 cases of uterine rupture, 2 haemorrhage shocks, 6 syndromes of prerupture, 6 umbilical cord prolapses at the third degree and 6 tears of the cervix. 20 caesarean sections have been performed as well as a turning of foetus in utero in 3 women, 4 hysterectomies, and a conservative suture with uterine tube ligation in the other cases. Often linked to a large multiparity, the neglected shoulder remains quite frequent in developing countries such as Madagascar and regular prenatal consultations together with a rigorous clinical exam are highly recommended by the authors to make an early diagnosis and provide a better care management.