obstructed labour - mela

[ArchivalUser]

when ever there is shoulder dystocia ,when all the usual method of traction fails ,what do you do?
a. maternal thigh flexion towards the shoulder
b.manual delivery of posterior shoulder
this is the quest from nbme 1.
please explain.

[ArchivalUser]

a. maternal thigh flexion towards the shoulder
McRoberts manuever

kaplan

[ArchivalUser]

how does thigh felxion help and when do you prefer delivery of posterior shoulder?

[ArchivalUser]

The Shoulder is stuck at the Pubic ramus and the shoulder cannot negotiate through the passage, by Mc Roberts manuever the flexion causes the impinged shoulder to move below it and helps it to pass and at the sametime it also helps the rotation of the fetus which was stopped because of Impacted shoulde at the pubis and this leads to safe delivery.

I hope this helps
Any one any other explanation

[ArchivalUser]

thanks sushrutha that was a very nice explanation,then when do we do delivrey of post.shoulder manually?

[ArchivalUser]

I think after this Manuever fails or if there is any contraindiaction, even if this fails or fetus is in distress Zavanelli Manuever I guess and C -section is a part of this
I hope this helps