Shoulder dystocia is suspected during a delivery after the delivery of the head, obstetrician asks the assistants to sharply flex the legs towards the abdomen. What is this maneuver?
Correct Answer: McRobes maneuver
Description: The McRobes maneuverThe maneuver consists of removing the legs from the stirrups and sharply flexing the thighs up toward the abdomen. The procedure caused straightening of the sacrum relative to the lumbar veebrae, rotation of the symphysis pubis toward the maternal head, and a decrease in the angle of pelvic inclination. Although this does not increase pelvic dimensions, pelvic rotation cephalad tends to free the impacted anterior shoulder.Of rotational maneuvers, Woods (1943) repoed that by progressively rotating the posterior shoulder 180 degrees in a corkscrew fashion, the impacted anterior shoulder could be released. This is frequently referred to as the Wood's corkscrew maneuver. Rubin (1964) recommended two maneuvers. First, the fetal shoulders are rocked from side to side by applying force to the maternal abdomen. If this is not successful, the pelvic hand reaches the most easily accessible fetal shoulder, which is then pushed toward the anterior surface of the chest. This maneuver most often abducts both shoulders, which in turn produces a smaller bisacromial diameter. This permits displacement of the anterior shoulder from behind the symphysis With an all- fours maneuver , also called the Gaskin maneuver, the paurient rolls onto her knees and hands. Here, downward traction against the head and neck attempts to free the posterior shoulder The Zavanelli maneuver involves replacement of the fetal head into the pelvis followed by cesarean delivery Reference: William's obstetrics; 25th edition
Category:
Gynaecology & Obstetrics
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