Shoulder dystocia

Question 1

What is Shoulder dystocia?

Answer 1

shoulder gets stuck behind pubic bone

obs emergency

Question 2

Order of management in shoulder dystocia?

Answer 2

External (90% success)

episiotomy before
Internal manvoures

Question 3

What external manoeurveres are done?

Answer 3

McRobert’s manoeuvre (patient lie on back with hips flexed and abducted)

Apply suprapubic pressure!

Question 4

What pressure can you apply to mcroberts manoeuvre?

Answer 4

Suprapubic pressure

Question 5

What order to perform internal manouveres?

Answer 5

Rubins

Woods

Delivery posterior arm

Question 6

What is the rubins manoeuvre?

Answer 6

insert hand behind anterior shoulder and push towards babys chest

Question 7

What is woods screw manouevre?

Answer 7

insert second hand (after rubins) to apply pressure to front of posterior shoulder to aid rotation

Question 8

Shoulder dystocia can cause damage to upper brachial plexus which can cause what palsy?

Answer 8

Erbs palsy : adduction and internal rotation of right arm

Question 9

What is the position of erbs palsy called?

Answer 9

‘Waiter’s tip’

Question 10

What is the turtle neck sign?

Answer 10

foetal head retracts back into perineum : shoulder dystocia

Question 11

In what position are internal manoeuvres done?

Answer 11

All four

Question 12

What is cleidotomy or symphysiotomy?

Answer 12

Division of foetal clavicle or maternal symphysial ligament

Question 13

What is the zavanelli mavoeuvere?

Answer 13

Replace head in canal and delivery with c section

Question 14

What dermatones are affected in Erb’s palsy?

Answer 14

C5-C6