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
            Sword and Scale by Sword and Scale

            Sword and Scale

            62,651 Listeners

            The Curbsiders Internal Medicine Podcast by The Curbsiders Internal Medicine Podcast

            The Curbsiders Internal Medicine Podcast

            3,349 Listeners

            The Daily by The New York Times

            The Daily

            112,250 Listeners

            Up First from NPR by NPR

            Up First from NPR

            56,677 Listeners

            Where Should We Begin? with Esther Perel by Esther Perel Global Media

            Where Should We Begin? with Esther Perel

            14,899 Listeners

            Call Her Daddy by Alex Cooper

            Call Her Daddy

            165,152 Listeners

            CREOGs Over Coffee by CREOGs Over Coffee

            CREOGs Over Coffee

            552 Listeners

            As a Woman by Natalie Crawford, MD

            As a Woman

            1,102 Listeners

            Spoonful of Sugar by Ria Mulherkar

            Spoonful of Sugar

            72 Listeners

            The Ezra Klein Show by New York Times Opinion

            The Ezra Klein Show

            15,942 Listeners

            Two Hot Takes by Morgan Absher

            Two Hot Takes

            7,933 Listeners

            Clerkship Ready: Pediatrics by MedReady

            Clerkship Ready: Pediatrics

            23 Listeners

            Good Hang with Amy Poehler by The Ringer

            Good Hang with Amy Poehler

            10,812 Listeners