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Book contents

Chapter 62 - Shoulder Dystocia

from Section 6 - Late Prenatal – Obstetric Problems

Published online by Cambridge University Press:  15 November 2017

David James
University of Nottingham
Philip Steer
Imperial College London
Carl Weiner
University of Kansas
Bernard Gonik
Wayne State University, Detroit
Stephen Robson
University of Newcastle
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Shoulder dystocia is defined as a vaginal cephalic delivery that requires additional obstetric maneuvers to deliver the fetus after gentle traction has failed. It occurs when either the anterior shoulder impacts behind the maternal symphysis or, less commonly, the posterior shoulder impacts over the sacral promontory. Evidence-based algorithms for the management of shoulder dystocia recommend resolution maneuvers designed to improve the relative dimensions of the maternal pelvis (McRoberts’ position and all-fours position), reduce the diameter of the fetal shoulders (suprapubic pressure and delivery of the posterior arm) and/or move the fetal shoulders into a wider pelvic diameter (suprapubic pressure and internal rotational maneuvers).

High-Risk Pregnancy
Management Options
, pp. 1775 - 1787
Publisher: Cambridge University Press
First published in: 2017

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