During delivery, the fetal head delivers but then retracts against the perineum (turtle sign) and the shoulders do not follow. What is the first manoeuvre?
Answer and explanation
Correct answer: D. Call for help and perform the McRoberts manoeuvre with suprapubic pressure
- Step 1: This is shoulder dystocia, an obstetric emergency.
- Step 2: McRoberts flexes and abducts the maternal hips and suprapubic pressure helps release the anterior shoulder.
Answer
Call for help and perform the McRoberts manoeuvre with suprapubic pressure.
Why not the others: Pull the head firmly downward with traction until the shoulders deliver: Traction on the head risks brachial plexus injury. Request immediate caesarean section in theatre: Caesarean is not appropriate for a delivering baby. Apply strong fundal pressure from the top of the uterus to push the baby out: Fundal pressure worsens impaction.
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