Shoulder dystocia is an unpredictable emergency with risk of injury to both mother and fetus. There are several techniques that can facilitate delivery and research has shown that familiarity with a systematic approach and frequent multidisciplinary team simulations are important to improve perinatal outcomes.
The patient is petite, term laboring patient who is pushing. She is a G2P1, at 40 weeks and 5 days. Medical history: all normal. OB history: all normal but diet controlled gestational diabetes. She has an epidural infusing.
Patient’s vital signs are stable and normal: Temp 98.7 F, P 100, R 20, BP 122/84, Pulse ox 98% on room air.
Fetal status: 130’s with moderate variability, no accelerations, variable decelerations to the 90’s with pushing. Contractions every 2-3 min. Pt is pushing well.
- Demonstrate early recognition and communication of shoulder dystocia to the team Verbalize the importance of calling for help in the event of a shoulder dystocia
- Demonstrate appropriate order and correct use of evidence-based maneuvers to quickly resolve shoulder dystocia
- Recognize the correct timing and procedure for McRoberts’s maneuver Recognize the correct timing and procedure for suprapubic pressure Recognize the correct timing and procedure for attempting Gaskin maneuver
ACOG Practice Bulletin (2017). Retrieved 6.28.22 from:
Baxley, E. G., & Gobbo, R. W. (2004). Shoulder dystocia. American Family Physician, 69(7), 1707-1714.
Draycott, T. J., Crofts, J. F., Ash, J. P., Wilson, L. V., Yard, E., Sibanda, T., & Whitelaw, A. (2008). Improving neonatal outcome through practical shoulder dystocia training. Obstetrics & Gynecology, 112(1), 14-20.
Grobman, W. A., Miller, D., Burke, C., Hornbogen, A., Tam, K., & Costello, R. (2011). Outcomes associated with introduction of a shoulder dystocia protocol. American journal of obstetrics and gynecology, 205(6), 513-517.