shoulder dystocia

Question 1

definition

Answer 1

It entails the inability to deliver the body of the fetus using gentle traction, the head having already been delivered. It usually occurs due to impaction of the anterior fetal shoulder on the maternal pubic symphysis.

Question 2

Key risk factors

Answer 2

fetal macrosomia (hence association with maternal diabetes mellitus)
high maternal body mass index
diabetes mellitus
prolonged labour

Question 3

management

Answer 3

Mcroberts manouvre : this manoeuvre entails flexion and abduction of the maternal hips, bringing the mother’s thighs towards her abdomen
episiotomy
symphysiotomy and zavanelli not recommended

Question 4

complications

Answer 4

maternal
postpartum haemorrhage
perineal tears
fetal
brachial plexus injury
neonatal death