A 27-year-old G1P0 woman at 39 weeks' gestation presents to the labor and delivery suite and progresses through the stages of labor normally. During delivery of the infant, the head initially progresses beyond the perineum and then retracts. Gentle traction does not facilitate delivery of the infant.Which of these options is the first step in the management:
This patient has shoulder dystocia as head initially progresses beyond the perineum and then retracts which is called as Turtle sign.
Turtle sign positive: Head delivers but retracts against symphisis pubis.
Shoulder Dystocia Drill
Abduct mothers thigh and apply suprapubic pressure.
Apply fundal pressure.
Flex mothers thigh against her abdomen.
Push infants head back into the uterus and do cesarean section.