Shoulder Dystocia Flashcards
What is Shoulder Dystocia?
The anterior shoulder becomes impacted behind the maternal pubic symphysis
What is shoulder dystocia a form of?
Obstructed labour
What are some of the main risk factors of shoulder dystocia?
Maternal gestational diabetes
Macrosomia
Advanced maternal age
Maternal short stature/small pelvis
How does shoulder dystocia present?
Retraction of the fetal head (Turtle-neck sign)
Failure of restitution
Failure of descent of the foetal shoulders following delivery of the head
What is shoulder dystocia associated with in the mother?
Postpartum haemorrhage
Perineal tears
What is shoulder dystocia associated with in the baby?
Brachial plexus injury
Hypoxic brain damage
What is the first line management of shoulder dystocia?
McRoberts Manoeuvre
What is McRoberts manoeuvre?
Hyperflexion and abduction of the mother’s hips, bringing her thighs to the abdomen
What might accompany McRoberts manoeuvre?
Applied suprapubic pressure
What brachial plexus injuries can result from shoulder dystocia?
Erb’s palsy
Klumpke’s palsy
What is erb’s palsy?
Damage to the upper brachial plexus
How can damage to the nerve roots with erb’s palsy present?
Adduction and internal rotation of the arm, with pronation of the forearm
What is the term used for the phsyical position in erb’s palsy?
Waiter’s tip
