A 40-year-old multipara at 40 weeks gestation experiences sudden cephalic delivery, but the infant's anterior shoulder becomes impacted behind the maternal symphysis pubis (shoulder dystocia). What is the first-line non-manipulative maneuver?
Answer and explanation
Correct answer: C. McRoberts maneuver (hyperflexion of maternal thighs onto abdomen)
- Step 1: Shoulder dystocia is an obstetric emergency with risk of fetal brachial plexus injury (Erb palsy) and asphyxia.
- Step 2: The McRoberts maneuver (hyperflexing the mother's hips against her abdomen) flattens the lumbosacral spine and rotates the symphysis pubis cephalad, releasing the shoulder in over 40% of cases.
- Step 3: Gentle suprapubic pressure may be applied simultaneously; fundal pressure is strictly contraindicated.
Answer
McRoberts maneuver (hyperflexion of maternal thighs onto abdomen).
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