Obstetrics

Question 1

What is the algorithm for shoulder dystocia?

Answer 1

Ask for help. This involves preparing for the help of an obstetrician, for anesthesia, and for pediatrics for subsequent resuscitation of the infant that may be needed if the methods below fail.
Leg hyperflexion (McRoberts' maneuver)
Lower head of bed
Anterior shoulder disimpaction (suprapubic pressure)
Rubin maneuver (cork screw)
Manual delivery of posterior arm
Episiotomy
Roll over on all fours