During delivery, the baby’s head was delivered but shoulders not delivered after one minute. What’s the next step ?
## Core Concept
Shoulder dystocia is an obstetric emergency that occurs when the anterior shoulder of the fetus becomes impacted against the maternal pubic bone after the head has been delivered. It requires immediate and effective management to prevent fetal injury or death.
## Why the Correct Answer is Right
The correct approach involves specific maneuvers to facilitate delivery. The McRoberts maneuver is typically the first step, involving hyperflexion of the mother's legs tightly to her abdomen to help alleviate the impaction. This is often followed by other maneuvers like the suprapubic pressure or the Woods' corkscrew maneuver if necessary.
## Why Each Wrong Option is Incorrect
- **Option A:** This option is incorrect because it does not specify an appropriate immediate action for shoulder dystocia.
- **Option B:** Similarly, this option lacks specificity and does not represent a recognized first-line intervention for shoulder dystocia.
- **Option C:** This might involve some delay or inappropriate action that could worsen the situation.
## Clinical Pearl / High-Yield Fact
A key clinical pearl is the "HELPERR" sequence for managing shoulder dystocia: **H**yperflexion of legs (McRoberts maneuver), **E**xternal suprapubic pressure, **L**ook for other causes, **P**erineal pressure, **E**ither rotational maneuvers (Woods' corkscrew) or **R**oll the patient onto her hands and knees, **R**eady for episiotomy if necessary.
## Correct Answer Line
**Correct Answer: D. McRoberts maneuver.**