Shoulder dystocia

Treatment

HELPER

H call for help

E episiotomy (or episioproctotomy) to increase the anetroposterior diameter of passage

L Legs flex (McRoberts maneuver)

P Pressure- suprapubic pressure and Rubin’s maneuver (applying shoulder pressure to the fetus to decreases the bisacromial diameter)

E Enter the vagina and attempt Wood’s corkscrew maneuver by pushing the most accessible shoulder toward the chest to corkscrew the shoulders through

R Remove posterior arm by sweeping it across the chest and bring fetal hand to the chin, grasp and pull out of the birth canal and across the face

Source

6/30/09 DONALDSON (from "Kaji Questions")