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02.07.2013

Shoulder dystocia, girl ab workouts tumblr - Within Minutes

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This condition is an emergency and the best strategy is to have in place a defined shoulder dystocia protocol to help health care professionals cope with the condition. Episiotomy should be considered throughout the management of shoulder dystocia but is necessary only to make more room if rotation manoeuvres are required. The hand of an assistant should be placed suprapubically over the foetal anterior shoulder applying pressure in a cardiopulmonary resuscitation style with a downward and lateral motion on the posterior aspect of the foetal shoulder. These manoeuvres attempt to manipulate the fetus to rotate the anterior shoulder into an oblique plane and under the maternal symphysis.
If the manoeuvres described in the HELPERR shoulder dystocia protocol mnemonic are unsuccessful, several techniques have been described as ‘last-resort’ manoeuvres.
Direct upward pressure on the mid-portion of the foetal clavicle; reduces the shoulder-to-shoulder distance. General anesthesia is induced and cesarean incision is performed, after which the surgeon rotates the infant transabdominally through the hysterectomy incision, allowing the shoulder to rotate, much like a Woods corkscrew manoeuvre.


Following the successful delivery of the baby after inplementation of a shoulder dystocia protocol, proper documentation is necessary for two reasons. In one tape you will see demonstrations of normal delivery, shoulder dystocia, McRobert's maneuver, suprapubic pressure, clavicle fracture, oxygen supply to the baby, and Wood's screw maneuver and more. These manoeuvres can be difficult to perform when the anterior shoulder is wedged beneath the symphysis.
The elbow then should be flexed and the forearm delivered in a sweeping motion over the fetal anterior chest wall. Often, the shoulder will dislodge during the act of turning, so that this movement alone may be sufficient to dislodge the impaction.
An operating team, anesthesiologist, and physicians capable of performing a cesarean delivery must be present, and this manoeuvre should never be attempted if a nuchal cord previously has been clamped out and cut.
It should be used only when all other manoeuvres have failed and capability of cesarean delivery is unavailable.


The first is because the documentation would prove useful in developing better techniques to deal with the condition; secondly because shoulder dystocia is an important reason for initiating medico-legal action. Because most cases of shoulder dystocia can be relieved with the McRoberts manoeuvre and suprapubic pressure, many women can be spared a surgical incision. In addition, once the position change is completed, gravitational forces may aid in the disimpaction of the foetal shoulders.



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