L9: Fetal Dystocia

Question 1

Def of Fetal Dystocia

Answer 1

• Difficulty in delivery of fetus due to abnormal fetal size)

Question 2

Etiology of Fetal Dystocia

Answer 2

Question 3

Def of Macrosomia

Answer 3

• Fetal weight is > 4000 gm (> 4500 gm by ACOG).

Question 4

Etiology of Macrosomia

Answer 4

Question 5

Complications of Macrosomia

Answer 5

Question 6

Dx of Macrosomia

Answer 6

Question 7

Management of Macrosomia

Answer 7

Question 8

Def of Shoulder Dystocia

Answer 8

• Failure of delivery of shoulders after delivery of head despite performing ordinary obstetric maneuvers.

Question 9

Incidence of Shoulder Dystocia

Answer 9

1-1.5% in fetuses e weight & 4000 gm

Question 10

Etiology of Shoulder Dystocia

Answer 10

• Pre-labor
• labor Related

Question 11

Etiology of Shoulder Dystocia

• Pre-labor factor

Answer 11

Question 12

Etiology of Shoulder Dystocia

• Labor factor

Answer 12

Question 13

Complications of Shoulder Dystocia

Answer 13

Question 14

Predection of Shoulder Dystocia

Answer 14

• Presence of risk factors of macrosomia.
• Ultrasonographic assessment of fetal weight.

Question 15

CP of Shoulder Dystocia

Answer 15

Question 16

Prevention of Shoulder Dystocia

Answer 16

Question 17

Management of Shoulder Dystocia

Answer 17

Question 18

Management of Shoulder Dystocia

• Intro

Answer 18

Question 19

Maneuvers in Shoulder Dystocia

Answer 19

• Gentle Downward Traction with suprapubic Pressure
• McRobert’s Maneuver
• Wood’s Screw Maneuver
• Bringing down posterior arm
• Zavanelli maneuver (cephalic replacement
  & doing CS)
• Others

Question 20

Maneuvers in Shoulder Dystocia

• Gentle Downward Traction with suprapubic Pressure

Answer 20

Question 21

Maneuvers in Shoulder Dystocia

• McRoberts’s Maneuver

Answer 21

Question 22

Maneuvers in Shoulder Dystocia

• Wood’s Screw Maneuver

Answer 22

Question 23

Maneuvers in Shoulder Dystocia

• Bringing Down Posterior Arm

Answer 23

Question 24

Maneuvers in Shoulder Dystocia

• Zavanelli Maneuver (Cephalic Replacement & Doing CS)

Answer 24

Question 25

Maneuvers in **Shoulder Dystocia** - Fracture of Clavicle

Answer 25

- 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

Question 26

Maneuvers in **Shoulder Dystocia** - Cleidotomy

Answer 26

- Cutting clavicle by scissors (done for dead fetus).

Question 27

Maneuvers in **Shoulder Dystocia** - Symphysiotomy

Answer 27

- May be done to overcome contracted pelvis.

Question 28

Maneuvers in **Shoulder Dystocia** - Abdominal Rescue

Answer 28

- Low transverse hysterotomy is performed & fetal shoulder is assisted below symphysis pubis followed by vaginal delivery of fetus.

Question 29

Maneuvers in **Shoulder Dystocia** - All Four maneuver

Answer 29

- Patient is guided to all four positions on her hands & knee, Increase the pelvic capacity by 30%

Question 30

Maneuvers in **Shoulder Dystocia** - Squatting Position

Answer 30

It is suggested to increased capacity of pelvic outlet.

Question 31

Maneuvers in **Shoulder Dystocia** - Rotation of fetal shoulder by Shute parallel forceps

Answer 31

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