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13 Cards in this Set
- Front
- Back
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What are some risk factors for shoulder dystocia?
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Prior shoulder dystocia
Gest diabetes, macrosomia postdates preg, short mom |
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What signs tell you that shoulder dystocia is occurring?
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-Fetal head retracts (turtle)
-Gentle traction does not effect delivery |
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What should you do if you identify shoulder dystocia?
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HELPERR
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What is HELPERR?
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Call for Help
Episiotomy evaluation Legs - McRoberts Pressure - suprapubic Enter maneuvers Retrieve the posterior arm Roll mom over on all fours |
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What is the power of the effect of McRoberts Maneuver?
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Reduces >40% of shoulder dystocias in and of itself!
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What are the 3 Enter maneuvers?
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1. Rubin 2
2. Wood's screw 3. Reverse wood's screw |
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How do you accomplish the Rubin 2?
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Approach the ANTERIOR shoulder from behind, exert pressure on the scapula
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How do you accomplish the Wood's Screw?
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In addition to the Rubin 2, approach the POSTERIOR shoulder from the front
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How do you accomplish the reverse wood's screw?
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Approach the posterior shoulder from behind - to turn baby in opposite direction
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Which arm do you deliver in shoulder dystocia if turning was successful?
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The POSTERIOR arm; follow down to elbow, flex arm at elbow, sweep across fetal chest
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What can you do if Enter maneuvers do not work?
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Rol the patient to all fours and try the Enter maneuvers in that position
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What is the Zavanelli maneuver?
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Cephalic replacement followed by emergent c/s delivery
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When should you NOT do a Zavanelli's maneuver?
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If the nuchal cord has been clamped/cut
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