L9: Fetal Dystocia Flashcards
Def of Fetal Dystocia
- Difficulty in delivery of fetus due to abnormal fetal size)
Etiology of Fetal Dystocia
Def of Macrosomia
- Fetal weight is > 4000 gm (> 4500 gm by ACOG).
Etiology of Macrosomia
Complications of Macrosomia
Dx of Macrosomia
Management of Macrosomia
Def of Shoulder Dystocia
- Failure of delivery of shoulders after delivery of head despite performing ordinary obstetric maneuvers.
Incidence of Shoulder Dystocia
1-1.5% in fetuses e weight & 4000 gm
Etiology of Shoulder Dystocia
- Pre-labor
- labor Related
Etiology of Shoulder Dystocia
- Pre-labor factor
Etiology of Shoulder Dystocia
- Labor factor
Complications of Shoulder Dystocia
Predection of Shoulder Dystocia
- Presence of risk factors of macrosomia.
- Ultrasonographic assessment of fetal weight.
CP of Shoulder Dystocia
Prevention of Shoulder Dystocia
Management of Shoulder Dystocia
Management of Shoulder Dystocia
- Intro
Maneuvers in Shoulder Dystocia
- Gentle Downward Traction with suprapubic Pressure
- McRobert’s Maneuver
- Wood’s Screw Maneuver
- Bringing down posterior arm
- Zavanelli maneuver (cephalic replacement
& doing CS) - Others
Maneuvers in Shoulder Dystocia
- Gentle Downward Traction with suprapubic Pressure
Maneuvers in Shoulder Dystocia
- McRoberts’s Maneuver
Maneuvers in Shoulder Dystocia
- Wood’s Screw Maneuver
Maneuvers in Shoulder Dystocia
- Bringing Down Posterior Arm
Maneuvers in Shoulder Dystocia
- Zavanelli Maneuver (Cephalic Replacement & Doing CS)
Maneuvers in Shoulder Dystocia
- Fracture of Clavicle
- Can be done to I diameter of shoulder (it is done by upward pressure against mid portion of clavicle to avoid injury of subclavian vessels
Maneuvers in Shoulder Dystocia
- Cleidotomy
- Cutting clavicle by scissors (done for dead fetus).
Maneuvers in Shoulder Dystocia
- Symphysiotomy
- May be done to overcome contracted pelvis.
Maneuvers in Shoulder Dystocia
- Abdominal Rescue
- Low transverse hysterotomy is performed & fetal shoulder is assisted below symphysis pubis followed by vaginal delivery of fetus.
Maneuvers in Shoulder Dystocia
- All Four maneuver
- Patient is guided to all four positions on her hands & knee, Increase the pelvic capacity by 30%
Maneuvers in Shoulder Dystocia
- Squatting Position
It is suggested to increased capacity of pelvic outlet.
Maneuvers in Shoulder Dystocia
- Rotation of fetal shoulder by Shute parallel forceps
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