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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

Diabetes

1

Shoulder dystocia?

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

2

Erb palsy – weakness of what muscles? Nerves?

Deltoid, infraspinatus, flexor muscles of forearm

C5, C6

3

Risk factors for shoulder dystocia?

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

4

When to diagnose shoulder dystocia?

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

5

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

6

Type of pressure not to use with shoulder dystocia?

Fundal