A 26- year old G3P2L2 at 40 weeks presents in second stage of labour. The baby’s head delivers spontaneously, but then retracts back against the perineum, even with downward traction, the baby’s anterior shoulder fails to deliver. All of the following are appropriate next steps in the management of this patient EXCEPT
Correct Answer: Instruct the nurse to apply fundal pressure
Description: A shoulder dystocia occurs when the fetal shoulders fail to spontaneously deliver secondary to impaction of the anterior shoulder against the pubic bone after delivery of the head has occurred. Management of Shoulder Dystocia - Call for help Suprapubic pressure to disengage the anterior shoulder Mc Robe's maneuver (flexing maternal legs upon the abdomen) Wood's corkscrew maneuver (rotating the posterior shoulder) and delivery of the posterior shoulder Zavanelli Restitution Gaskin maneuver - In a Knee chest position A generous episiotomy should always be made to allow manipulations There is no role for fundal pressure.
Category:
Gynaecology & Obstetrics
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