A diabetic female delivers head of the baby even after one minute the shoulder was not delivered. Which of the following is done?
Ans. (b) McRoberts maneuverRef: Williams Obstetrics 25th Ed; Page No-521* The McRoberts maneuver requires two assistants. Each assistant grasps a leg and sharply lexes the maternal thigh toward the abdomen. This maneuver will resolve most cases of shoulder dystocia.The maneuver consists of removing the legs from the stirrups and sharply flexing the thighs up onto the abdomen. The assistant is also providing suprapubic pressure simultaneouslyShoulder DystociaDiagnosis* This diagnosis is made when delivery of the fetal shoulders is delayed after delivery of the head.* It is more commonly associated with fetal shoulders in the anterior-posterior plane, with the anterior shoulder impacted behind the pubic symphysis.* It occurs in 1% of the deliveries case and it may result in permanent neonatal neurologic damage in 2% of cases.Risk Factors* It Includes obesity, maternal diabetes, and postdates pregnancy, which are associated with fetal macrosomia.* The incidence may increase with birth weight, half of shoulder dystocia's occur in fetuses <4,000grams.Management* Suprapubic pressure* Maternal thigh flexion (McRoberts maneuver),* Internal rotation of the fetal shoulders to the oblique plane (Woods "corkscrew" maneuver)* Manual delivery of the posterior arm, and* Zavanelli maneuver (cephalic replacement).
Cleidotomy
McRoberts maneuver
C-section
lateral traction
Operative Obs