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Retraction of the baby's head back into the vagina, known as "turtle sign" is suggestive of shoulder dystocia. [3] [1] It is a type of obstructed labour. [4] Although most instances of shoulder dystocia are relieved without complications to the baby, the most common complications may include brachial plexus injury, or clavicle fracture.
Shoulder dystocia is often signaled by retreat of the head between contractions when it has already been delivered ("turtle sign"). Treatment includes the McRoberts maneuver , where the mother flexes her thighs up to her stomach with her knees wide apart as pressure is applied on her lower abdomen, and Wood's screw maneuver , where the ...
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 ]
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.
The Zavanelli maneuver is an obstetric maneuver that involves pushing back the delivered fetal head into the birth canal in anticipation of performing a cesarean section in cases of shoulder dystocia. [1] [2] The Zavanelli maneuver is performed only after other maneuvers have failed, as it is associated with high risk to both the mother and the ...
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.
Shoulder presentations are uncommon (about 0.5% of births) [1] since, usually, toward the end of gestation, either the head or the buttocks start to enter the upper part of the pelvis, anchoring the fetus in a longitudinal lie. It is not known in all cases of shoulder presentation why the longitudinal line is not reached, but possible causes ...
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 ]