Tuesday Sept, 9th, 2008. morning. we had lecture on another case in gynaecology (2nd day of women issues labour). lecture starts at 10.30am but AE group only arrived around 11am...lecture we heard was at 11 am....please dont blame us on this...
Shoulder Dystorcia bring fear to doctors and midwives (Weiss, no date) from www.about.com
So, what happens in shoulder dystorcia? it happens when the baby shoulder, per se, got stuck if u see in outer view, it seems that the baby's head is stuck around the labia majora (Correct me!)
This fenomena carries risks; namely for the baby, leads to fracture (e.g. clavicle), distress...
For the mother, it will creates injury to the cervix, vagina and ... add more here please
This happens when the baby is big (macrosomia) and post term pregnancy(which leads to midforceps delivery).
Amazing news! Management of Shoulder Dystorcia has their own algorithm
1. Call for help, inform gynae doctor and paediatricians
2. Traction assisted with the mother expulsive effort
3. Large episiotomy ( normal is around 1 cm or it depends)
3. Adequate analgesia (usu. Pethidine IM)
4. McRobert's manoeuvre (flexion of the thigh and then abduction, requires 2 helps)
5. Suprapubic pressure
6. Woods Corkscrew manoeuvre
7. Delivery of Posterior Shoulder
8. Worst comes worst, Rubin Reverse corkscrew, All Fourrs, Zavanelli, Fracture the Clavicle, Cleidotomy (cutting the clavicle) and Symphysiotomy.
N.b this algorithm comes if each attempt does not work effectively.
Thanx!! Comments encourage...
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