Shoulder dystocia is seen predominantly in: March 2007
Ans. C: Anencephaly There are well-recognised risk factors, such as diabetes, fetal macrosomia,post maturity, multiparity, anencephaly, fetal ascites and maternal obesity, but it is often difficult to predict. A number of obstetrical maneuvers are sequentially performed in attempt to facilitate delivery at this point,including : Gaskin maneuver involves moving the mother to an all fours position with the back arched, widening the pelvic outlet. McRobe's maneuver; Woods' screw maneuver which leads to turning the anterior shoulder to the posterior and vice versa. Jacquemier's maneuver, or delivery of the posterior shoulder first, in which the forearm and hand are identified in the bih canal, and gently pulled. More drastic maneuvers include Zavanelli's maneuver involves pushing the fetal head back in with performing a cesarean section. Intentional clavicular fracture, which reduces the diameter of the shoulder girdle that requires to pass through the bih canal. Symphisiotomy, which makes the opening of the bih canal laxer by breaking the connective tissue between the two pubes bones facilitating the passage of the shoulders. Don'ts in shoulder dystocia: Do not give traction over baby's head Do not apply fundal pressure.
Transverse lie
Cord around neck
Anencephaly
Hand prolapse