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Flashcards in Shoulder dystocia Deck (7)
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Patient in labor – head delivers but the shoulders do not: next step? Likely complication? Likely maternal comorbidity?

McRoberts maneuver (hyperflexion of the maternal hips onto abdomen) +/- suprapubic pressure

Postpartum hemorrhage in mother; brachial plexus injury (Erb palsy) in neonate



Shoulder dystocia?

Inability of the fetal shoulders to deliver spontaneously due to the impaction of the anterior shoulder behind the maternal synthesis pubis


Erb palsy – weakness of what muscles? Nerves?

Deltoid, infraspinatus, flexor muscles of forearm

C5, C6


Risk factors for shoulder dystocia?

1. Maternal obesity
2. Fetal macrosomia
3. Prolonged second stage of labor
4. Gestational diabetes


When to diagnose shoulder dystocia?

1. External rotation of fetal head is difficult
2. "Turtle sign" – fetal head may retract back toward maternal introitus


Other maneuvers for shoulder dystocia (Other than McRoberts maneuver and suprapubic pressure)?

1. Wood's corkscrew – progressively rotating posterior shoulder in 180° corkscrew fashion
2. Delivery of posterior arm
3. Zavanelli maneuver – Cephalic replacement with immediate cesarean section


Type of pressure not to use with shoulder dystocia?