Soft tissue dystocia - is it real?

[88nurse2010]

It seems that very obese patients (i.e. 300 lbs & barely over 5 ft tall) have babies that never engage in the pelvis. I've had older nurses refer to this as soft tissue dystoica. Some of the things I've read say that soft tissue dystocia is not real. It makes sense to me, especially for mom's who carry a lot of weight in their abdomen. Is soft tissue dystocia for real or do these ladies just need their care managed differently?

[mommy2boysaz]

I consider it soft tissue dystocia when the shoulders and body are difficult to get out, not due to the shoulders being caught on the pelvic bones (which is a true shoulder dystocia), but because there is sooo much "soft tissue" in the mother's pelvis and thighs. This is most definitely a "real" problem!