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Wood's screw maneuver is practiced in obstetrics when dealing with shoulder dystocia – a condition in which the fetal shoulders cannot easily pass through the vagina.In this maneuver the anterior shoulder is pushed towards the baby's chest, and the posterior shoulder is pushed towards the baby's back, [1] making the baby's head somewhat face the mother's rectum.
Shoulder dystocia occurs after vaginal delivery of the head, when the baby's anterior shoulder is obstructed by the mother's pubic bone. [ 3 ] [ 1 ] It is typically diagnosed when the baby's shoulders fails to deliver despite gentle downward traction on the baby's head, requiring the need of special techniques to safely deliver the baby. [ 2 ]
Obstructed labour, also known as labour dystocia, is the baby not exiting the pelvis because it is physically blocked during childbirth although the uterus contracts normally. [2] Complications for the baby include not getting enough oxygen which may result in death. [ 1 ]
Rubin's I and II maneuvers, rotational maneuver to deliver the baby in case of shoulder dystocia. [1] The Rubin's I maneuver is dislodging the anterior shoulder under pubic symphysis by adding suprapubic pressure while in the McRoberts' position. As a result, the bisacromial diameter is rotated from anteroposterior to oblique lie.
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Use for shoulder dystocia is controversial. [ 5 ] Currently the procedure is rarely performed in developed countries, but is still performed in "rural areas and resource-poor settings of developing countries" [ 7 ] where caesarean sections are not available, or where obstetricians may not be available to deliver subsequent pregnancies. [ 8 ]