SHOULDER DYSTOCIA

  • Do not panic
  • Do not use forceful traction on head
    • May cause severe damage to both child and mother
  • Go systematically through following steps:
  • Wipe baby’s face clean
  • Keep airways free
  • Use suction to remove mucus and meconium
  • Make a generous episiotomy.
    • This alone might solve the problem
  • Apply Loevset’s maneuver
    • Grasp lateral border of the scapula with four ulnar fingers of your hand
    • Rotate truncus 180°
    • Use right hand when the back is turned to the (mother’s) left and vice versa
    • As the birth canal is shorter anteriorly bringing the posterior shoulder anteriorly may deliver it
  • Repeat the maneuver
Loevset’s Maneuver
  • Fracture both clavicles
    • Decreases the overall dimension of the shoulders
  • Place the delivery hook under one axilla
  • Apply traction
  • Rotate truncus 180° (Loevset’s Maneuver)
Loevset’s Maneuver with delivery Hook
  • Perform symphysiotomy

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