Procedure Ready: Ob/Gyn

Shoulder dystocia

Listen Later

Definition: Failure to deliver fetal shoulders with normal downward traction 

Why we care: Baby hypoxia, brachial plexus injuries, maternal injuries

Risk factors: 

  • DM, excessive weight gain in pregnancy, S>D, Large baby
  • Hx of shoulder dystocia (~10-15% recurrence)
  • Turtling while pushing 

    • Prevention 

    • No real prevention as SD is very hard to predict 
    • Offer cesarean delivery if EFW is >5000g and no DM, or >4500g and any type of DM

      • What do to: 

      • Step back. If comfortable, can help minimize family interference. Calmly explain what is happening and what the docs are doing. 
      • Offer to be the Timekeeper. Write down times and what is happening. Announce every 2 minutes. 

        • What you’ll see: 

        • Prep: Hypothesize shoulder orientation for suprapubic pressure, place stool 
        • Announce problem- call for help
        • Maneuvers - McRobers, suprapubic
          • Posterior arm
          • Rotational: Wood’s screw, Rubin
          • Gaskins- all 4s
          • Episiotomy
          • Zavanelli 
            • ...more
            View all episodesView all episodes
            Download on the App Store
            Procedure Ready: Ob/GynBy Jennifer Doorey, MD, MS
            • 4.9
            • 4.9
            • 4.9
            • 4.9
            • 4.9

            4.9

            268 ratings

            More shows like Procedure Ready: Ob/Gyn

            View all
            AFP: American Family Physician Podcast by American Academy of Family Physicians

            AFP: American Family Physician Podcast

            696 Listeners

            JAMA Clinical Reviews by JAMA Network

            JAMA Clinical Reviews

            500 Listeners

            Behind The Knife: The Surgery Podcast by Behind The Knife: The Surgery Podcast

            Behind The Knife: The Surgery Podcast

            1,311 Listeners

            The Curbsiders Internal Medicine Podcast by The Curbsiders Internal Medicine Podcast

            The Curbsiders Internal Medicine Podcast

            3,376 Listeners

            Emergency Medical Minute by Emergency Medical Minute

            Emergency Medical Minute

            278 Listeners

            Core IM | Internal Medicine Podcast by Core IM Team

            Core IM | Internal Medicine Podcast

            1,150 Listeners

            Evidence Based Birth® by Rebecca Dekker, PhD, RN

            Evidence Based Birth®

            1,038 Listeners

            CREOGs Over Coffee by CREOGs Over Coffee

            CREOGs Over Coffee

            558 Listeners

            The Zero to Finals Medical Revision Podcast by Thomas Watchman

            The Zero to Finals Medical Revision Podcast

            141 Listeners

            The Clinical Problem Solvers by The Clinical Problem Solvers

            The Clinical Problem Solvers

            515 Listeners

            Harrison's PodClass: Internal Medicine Cases and Board Prep by AccessMedicine

            Harrison's PodClass: Internal Medicine Cases and Board Prep

            369 Listeners

            » Divine Intervention Podcasts by Divine-Favour Anene

            » Divine Intervention Podcasts

            999 Listeners

            Cram The Pance by Scott Shapiro PA-C

            Cram The Pance

            1,139 Listeners

            Normal Gossip by Normal Gossip

            Normal Gossip

            5,871 Listeners

            Ninja Nerd by Ninja Nerd

            Ninja Nerd

            323 Listeners

            Clerkship Ready: Pediatrics by MedReady

            Clerkship Ready: Pediatrics

            22 Listeners