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What is Shoulder dystocia is managed by: and explain in detail?
Ans. b. Supra pubic pressureRef: Williams Obstetrics 24th Ed; Page No-541SHOULDER DYSTOCIADiagnosisThis diagnosis is made when delivery of the fetal shoulders is delayed after delivery of the head.It is more commonly associated with fetal shoulders in the anterior-posterior plane, with the anterior shoulder impacted behind the pubic symphysis.It occurs in 1% of the deliveries case and it may result in permanent neonatal neurologic damage in 2% of cases.Risk FactorsIt Includes obesity, maternal diabetes, and postdates pregnancy, which are associated with fetal macrosomia.The incidence may increases with birth weight, half of shoulder dystocias occur in fetuses <4,000 grams.ManagementSuprapubic pressureMaternal thigh flexion (McRoberts maneuver)Internal rotation of the fetal shoulders to the oblique plane (Wood s "corkscrew" maneuver)Manual delivery of the posterior arm, andZavanelli maneuver (cephalic replacement).