shoulder dystocia
Shoulder dystocia is a complication of vaginal cephalic delivery. 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. Shoulder dystocia is a cause of both maternal and fetal morbidity.
rissk factors for shoulder dystocia
Key risk factors
fetal macrosomia (hence association with maternal diabetes mellitus)
high maternal body mass index
diabetes mellitus
prolonged labour
management of shoulder dystocia
McRobert’s manouver -this manoeuvre entails flexion and abduction of the maternal hips, bringing the mother’s thighs towards her abdomen
this rotation increases the relative anterior-posterior angle of the pelvis and often facilitates a successful delivery.
