Temporary Erb-Duchenne Palsy Without Shoulder Dystocia or Traction to the Fetal Head

2005 ◽  
Vol 106 (5, Part 1) ◽  
pp. 1110 ◽  
Author(s):  
Robert H. Allen ◽  
Edith D. Gurewitsch
Keyword(s):  
Shoulder Dystocia ◽  
Fetal Head

scholarly journals Visual Estimation of Force Applied During Simulated Deliveries Complicated by Shoulder Dystocia

2018 ◽  
Vol 08 (04) ◽  
pp. e206-e211
Author(s):  
Margaret Walters ◽  
Allison Eubanks ◽  
Elizabeth Weissbrod ◽  
John Fischer ◽  
Barton Staat ◽  
...  
Keyword(s):  
Study Design ◽  
Pubic Symphysis ◽  
Shoulder Dystocia ◽  
Objective Measurement ◽  
Excessive Force ◽  
Visual Estimation ◽  
Average Amount ◽  
Fetal Head

Background Shoulder dystocia occurs when the fetal head delivers, but the shoulder is lodged behind the pubic symphysis. Training for these emergency deliveries is not optimized, and litigation can occur around a shoulder dystocia delivery. Objective Evaluate the ability of an outside observer to visually estimate the amount of traction applied to the fetal head during simulated deliveries complicated by shoulder dystocia. Study Design Simulated deliveries with an objective measurement of traction were randomly organized for estimation of traction applied. Videos show providers applying a “normal” (75 N) and “excessive” (150 N) amount of force in both a “calm” and “stressed” delivery. Results Fifty participants rated the amount of force applied. Observers estimated traction, on a scale from 1 to 5, higher in the 150-N deliveries as compared with 75-N deliveries (“calm” environment: 3.1 vs. 2.8, p < 0.001; and “stressed” environment: 3.2 vs. 2.8, p < 0.001). Only 15% of observers rated force “above average” or “excessive” in a “calm” environment, as opposed to 30% of observers in the “stressed” environment. Conclusion Observers are not able to determine when “excessive force” is used and are twice as likely to overestimate the force applied to a fetal head when an average amount of force is used and the delivery environment is stressful. Precis Observers are unable to determine when excessive traction is applied to the fetal head during simulated deliveries complicated by shoulder dystocia.

Temporary Erb-Duchenne Palsy Without Shoulder Dystocia or Traction to the Fetal Head

2005 ◽  
Vol 105 (Supplement) ◽  
pp. 1210-1212 ◽  
Author(s):  
Robert H. Allen ◽  
Edith D. Gurewitsch
Keyword(s):  
Shoulder Dystocia ◽  
Fetal Head

Temporary Erb-Duchenne Palsy Without Shoulder Dystocia or Traction to the Fetal Head

2005 ◽  
Vol 106 (5, Part 1) ◽  
pp. 1109 ◽  
Author(s):  
Herbert F. Sandmire ◽  
Robert K. DeMott
Keyword(s):  
Shoulder Dystocia ◽  
Fetal Head

scholarly journals The Carit Maneuver: A Novel Approach for the Relief of Shoulder Dystocia—A Case Series

2020 ◽  
Vol 10 (02) ◽  
pp. e133-e138
Author(s):  
Alfredo F Gei ◽  
Jorge Suarez Mastache ◽  
Luis D. Pacheco ◽  
Mariana Villanueva
Keyword(s):  
Cohort Study ◽  
Head And Neck ◽  
Mechanism Of Action ◽  
Case Series ◽  
Shoulder Dystocia ◽  
Fetal Head ◽  
Successful Intervention ◽  
Novel Approach ◽  
Posterior Shoulder ◽  
Maternal And Neonatal Outcomes

Abstract Objective The main purpose of this article is to describe the technique and mechanism of action of a novel intervention for the relief of shoulder dystocia we are labeling Carit maneuver. Methods We report a cohort study of eight cases of shoulder dystocia not relieved by the combination of McRobert's maneuver and suprapubic pressure treated with the Carit maneuver. This intervention involves the use of the fetal head and neck as the grasping point of the fetus to exert a ventral rotation of the fetal trunk, reduce the bi-acromial diameter, and deliver the posterior shoulder by passive displacement.In all these cases, the direction of the original head restitution, direction of exerted rotation, and side and location of delivery of the first shoulder were recorded. Maternal and neonatal outcomes were reviewed and reported. Results In all cases, the Carit rotational maneuver resulted in the delivery of the posterior shoulder in the transverse (4), oblique anterior (2), or direct anterior (2) diameters. No instances of neonatal depression or fetal acidemia were noted in this cohort. Conclusion The Carit maneuver is an original and successful intervention in the management of shoulder dystocia unresponsive to McRobert's maneuver and suprapubic pressure.

scholarly journals Intrauterine fetal death followed by shoulder dystocia and birth by modified posterior axillary sling method: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Angel Hoi Wan Kwan ◽  
Annie Shuk Yi Hui ◽  
Jacqueline Ho Sze Lee ◽  
Tak Yeung Leung
Keyword(s):  
Shoulder Dystocia ◽  
Intrauterine Fetal Death ◽  
Fetal Head ◽  
Successful Case ◽  
Posterior Shoulder ◽  
Variable Success ◽  
Pass Through ◽  
Narrow Space ◽  
Rubber Catheter ◽  
The Right

Abstract Background Various manoeuvres such as McRoberts position, suprapubic pressure, rotational methods, posterior arm extraction and all-four position (HELPERR) have been proposed for relieving shoulder dystocia with variable success. Posterior axillary sling method using a rubber catheter was proposed in 2009 but has not been widely used. We modified this method using ribbon gauzes and a long right-angle forceps and report a successful case. Case presentation A 44 years old parity one Chinese woman with a history of a caesarean delivery and poorly controlled type 2 diabetes mellitus was admitted to the Accident and Emergency Department for advanced stage of labour at term. Upon arrival, intrauterine fetal demise was diagnosed with severe asynclitism causing obstruction at the perineum. Episiotomy resulted in birth of the fetal head. The fetal posterior right shoulder, however, remained very high up in the pelvis and HELPERR methods failed to extract the shoulders. We then tied two long ribbon gauzes together, and guided its knot to the anterior aspect of the posterior axilla. By using a long right-angle forceps (24 cm long) to grasp the knot on the posterior side of the axilla and pulling it through, a sling was formed. Traction was then applied through the sling to simultaneously pull and rotate the posterior shoulder. A stillbirth of 3488 g was finally extracted. Conclusions We modified the sling method by using two ribbon gauzes, tied together and a right-angle forceps with several advantages. Compared to a rubber catheter, ribbon gauze with a knot can be easily held between the fingers for easy guidance past the fetal axilla. It is also thin, non-elastic and stiff enough to ensure a good grip for traction. The long and slim design of the right-angle forceps makes it easy to pass through a narrow space and reach the axilla high up in the pelvis. We emphasize simultaneous traction and rotation, so that the shoulders are delivered through the wider oblique pelvic outlet dimension.

Role of Decapitation in Management of A Case of Complete Shoulder Dystocia with Rupture Uterus - A Case Report

2021 ◽  
Vol 15 (11) ◽  
pp. 3043-3044
Author(s):  
Nadia Zahid ◽  
Muntiha Sarosh ◽  
Rakhshsanda Toheed ◽  
Mohammad Saa ◽  
Kokab Zia
Keyword(s):  
Uterine Rupture ◽  
Maternal Education ◽  
Bladder Wall ◽  
Time Lapse ◽  
Shoulder Dystocia ◽  
Maternal Complications ◽  
Fetal Head ◽  
Obstructed Labor ◽  
Uterine Scar ◽  
Scarred Uterus

Complete Shoulder dystocia in the presence of scarred uterus is an acute obstetrical emergency and if not properly handled can lead to serious fetal and maternal complications. A G5P4AO previous II cesarean sections, presented in emergency after delivery of fetal head and impacted shoulders, at a small private clinic in a village, four hours back. On laparotomy, there was uterine rupture from the previous uterine scar along with posterior bladder wall rupture . The shoulder dystocia was relieved by decapitation and breech extraction abdominally. Subtotal hysterectomy and repair of the bladder wall was done. This case highlight the dilemma of lack of regular antenatal care and maternal education, malpractices by untrained health professionals and time lapse in referral system that is still a very serious and major issue in developing countries like Pakistan . Keywords: Shoulder dystocia, obstructed labor, and uterine rupture

The Comparison of Intrapartum Sonographic Signs and Digital Examination in Fetus with Cephalic Presentation

2020 ◽  
Vol 103 (11) ◽  
pp. 1178-1184
Keyword(s):  
Pregnant Women ◽  
Cross Sectional Study ◽  
Head Position ◽  
Vaginal Examination ◽  
Fetal Head ◽  
Cross Sectional ◽  
Percent Agreement ◽  
Anterior Position ◽  
Fetal Head Position ◽  
Digital Vaginal Examination

Objective: The agreement of fetal head position examined by digital vaginal examination (DVE) and intrapartum sonographic signs (ISS) in pregnant women during labor. Materials and Methods: A cross-sectional study was conducted. Two hundred eight-term singleton pregnant women attending labor at Ramathibodi Hospital, Thailand with the fetal cephalic presentation, cervical dilatation of 4 to 8 cm, station –2 or below and no contraindication for DVE were enrolled. The DVE evaluating fetal head position was performed by the third-year obstetrical residents. After DVE, ISS via transabdominal ultrasound for determining fetal head position was obtained immediately by the first researcher. The DVE report and the ultrasonographic images of ISS were recorded separately. The fetal head position based on ISS was designated by the second researcher blinded to the DVE result. The agreement of DVE and ISS for determining fetal head position was analyzed. Results: Two hundred eight pregnant women were analyzed. The fetal head position detected by DVE was consistent with that of ISS at 41.3% (p<0.001). The most percent agreement was observed in the fetus with left occiput anterior position at 72.7% (p<0.001). The lowest percent agreement was found in the direct occiput posterior at 14.3% (p=0.243). Parity, gestational age, current body mass index, epidural analgesia, cervical effacement, caput succedaneum, molding, and station did not significantly affect the discrepancy between DVE and ISS. Conclusion: The agreement between DVE and ISS for evaluating the fetal head position was low. The ISS might be considered for evaluating the fetal head position. Keywords: Fetal head position, Intrapartum sonographic sign, Digital vaginal examination

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