Shoulder Dystocia Flashcards
WHAT IS SHOULDER DYSTOCIA ?
DURING THE DELIVERY OF THE BABY THE ANTERIOR SHOULDER IMPACTS ON THE SYMPHYSIS PUBIS.
HOW MANY BIRTHS DOES SHOULDER DYSTOCIA AFFECT?
1%
WHAT IS THE PROBLEM ? SHOULDER DYSTOCIA
BABIES SHOULDERS ARE TOO BIG FOR THE NARROW PELVIC OPENING
RISK FACTORS OF SHOULDER DYSTOCIA?
PREVIOUS SHOULDER DYSTOCIA
DIABETES MELLITUS
FETAL MACROSOMIA
MATERNAL OBESITY
PROLONGED FIRST STAGE
PROLONGED SECOND STAGE
AUGMENTATION OF LABOUR
INSTRUMENTAL DELIVERY
DOES IT JUST HAVE TO BE WOMEN WITH RISK FACTORS?
NO
ARE WOMEN WITH RISK FACTORS MORE LIKELY TO GET SHOULDER DYSTOCIA?
NO IN FACT WOMEAN WITH NO RISK FACTORS OCCUPY THE MAJORITY OF THE CASES.
WHAT DO CLINICIANS NEED TO BE AWARE OF WITH SHOULDER DYSTOCIA?
RISK FACTORS
DO CLINICIANS NEED TO BE ALERT FOR THE POSSIBILITY OF SHOULDER DYSTOCIA?
YES
SIGNS OF A SHOULDER DYSTOCIA?
DIFFICULT DELIVERY OF FACE AND CHIN
HEAD REMAINS TIGHTLY APPLIED TO THE VULVA
CHIN RETRACTION (TURTLE NECKING)
ANTERIOR SHOULDER FAILS TO DELIVER WITH ROUTINE AXIAL TRACTION
DONT PULL DOWN ON BABY’S HEAD.
WHAT SHOULD I KEEP IN LINE WHEN ANTERIOR SHOULDER FAILS TO DELIVER WITH ROUTINE AXIAL TRACTION ?
THE BABYS HEAD NEEDS TO BE KEPT IN LINE WITH THE SPINE
MANAGING SHOULDER DYSTOCIA
CALL FOR HELP
DISCOURAGE PUSHING
LIE THE WOMAN FLAT / MOVE TO THE EDGE OF THE BED/SOFA
McROBERTS POSITION
SUPRAPUBIC PRESSURE
ROTATE ONTO ALL FOURS
MIDWIVES CAN DO INTERNAL MANEUVERS PARAMEDICS CANNOT BUT THEY CAN ASSIST
WHAT DOES THE MCROBERTS POSITION DO?
TILTS THE PELVIS IN AN ATTEMPT TO MAKE THE OPENING WIDER/
HOW IS MCROBERTS DONE
LIE PT FLAT
STRAIGHTEN THE LEGS
HYPERFLEX HIPS SO KNEES ARE NEXT TO THE EARS
APPLY ROUTINE AXIAL TRACTION ON THE FETAL HEAD
WHAT IS ROUTINE AXIAL TRACTION?
Applying the same amount of pulling force as used during a typical childbirth in a straight line.
WHAT DIRECTION IS AXIAL TRACTION PERFORMED?
IN LINE WITH THE AXIS OF THE FETAL SPINE