Answers To Case 11 Shoulder Dystocia

Summary: A 25-year-old obese G2 PI woman is delivering at 42 weeks' gestation; the fetus appears clinically to be 3700 g (average weight). After a 4-hr first stage of labor and 2-hr second stage of labor, the head delivers but the shoulders do not easily deliver.

^ Next step in management: McRoberts' maneuver (hyperflexion of the maternal hips onto the maternal abdomen and/or suprapubic pressure).

^ Likely complication: A likely maternal complication is postpartum hemorrhage; a common neonatal complication is a brachial plexus injury such as Erb's palsy.

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