Shoulder Dystocia
🚨 Symptoms
Difficulty delivering baby's shoulders after head has been delivered (turtle sign – head retracts back), failure of shoulders to deliver with gentle traction, need for specific obstetric maneuvers
🔍 Causes
Fetal macrosomia (large baby), maternal diabetes, obesity, post-term pregnancy, previous shoulder dystocia, prolonged second stage of labour, assisted delivery (forceps/ventouse)
💊 Treatment
McRoberts maneuver (hyperflexion of maternal thighs), suprapubic pressure, rotational maneuvers (Woods screw, Rubin), delivery of posterior arm, all-fours position (Gaskin maneuver), cleidotomy (fracture clavicle), Zavanelli maneuver (rare), symphysiotomy (rare)
📝 Nursing Care
Assist with maneuvers, document timing and procedures, provide clear communication, prepare for neonatal resuscitation, monitor for complications (brachial plexus injury, fractures), provide emotional support to parents
Source: NHS Scotland. For educational purposes only.