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Management of Shoulder Dystocia: Critical Thinking in Clinical Decision Making

Prasuna Jelly , Prasuna Jelly

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Journal of Nurse Midwifery and Maternal Health 2(2):p 109-113, May-Aug 2016. | DOI: DOI: http://dx.doi.org/10.21088/jnmmh.2454.7506.2216.12

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Abstract

  Shoulder dystocia refers to difficulty in delivery of the fetal shoulders. It occurs in 0.2 to 2 % of births and can be a distressingemergencyin obstetrics. The goal of management is to prevent fetal asphyxia, while avoiding physical injury (eg, Erb’s palsy, bone fractures). The overall incidence of shoulder dystocia varies based on fetal weight. The incidence of shoulder dystocia is generally reported to be between 0.5 % and 1.5% with scattered reports listing values both higher and lower. Management of shoulder dystocia commonly includes Recognition of shoulder dystocia, Call for help, McRobert’s maneuver, Suprapubicpressure, Evaluate the need for an episiotomy, Internal maneuvers, Gaining internal vaginal access, Delivery of the posterior arm, Internal rotational maneuvers, All fours position, Documentation. It is important to remember to avoid traction and fundal pressure while attempting to deliver the shoulder dystocia.

Keywords: Shoulder dystocia; Suprapubicpressure; Episiotomy; Internal maneuvers.

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DOI: DOI: http://dx.doi.org/10.21088/jnmmh.2454.7506.2216.12

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