Shoulder dystocia is an obstetrical emergency. While there are associated risk factors, they are poor at predicting shoulder dystocia. The majority of cases will occur in women without diabetes whose offspring are within normal weight range. Nor is there any evidence that shoulder dystocia can be prevented. Complications include PPH and brachial plexus injuries. ACOG published guidance in 2017 that has been reaffirmed (2019).
Failure to deliver the fetal shoulder(s) with gentle downward traction on the fetal head, requiring additional obstetric maneuvers to effect delivery
McRoberts maneuver: Best first step (Level B Evidence)
Posterior Shoulder Delivery to reduce shoulder diameter (Level C Evidence)
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