Shoulder Dystocia

• Should Dystocia 


  Anterior shoulder of infant is unable to pass the maternal pelvis
• Should Dystocia

  Due to lack of external rotation during the 2nd stage of labor
• Shoulder dystocia

  Causes: Cephalopelvic Disproportion (CPD)

  • power: hypotonic contraction
  • passenger: LOP, macrosomia, <4 kg
  • passageway: small pervis
• Shoulder dystocia

  Sign:

  • Turtle sign - fetal head retracts against the maternal cervix
• Shoulder dystocia

  Management:

  • no fundal push = causes dislocation and fracture
  • McRoberts Maneuver: involves an obstetrician or other healthcare provider flexing your thighs toward your abdomen (+ suprapubic pressure)
  • emergency CS