How competent are you (or your staff) with shoulder dystocia?

Shoulder dystocia-when the fetal head retracts or recoils against the maternal perineum ("turtle sign") and external rotation is not accomplished-occurs in approximately 1 of every 200 deliveries. It's often diagnosed after the emergence of the fetal head when delivery is prevented by impaction of the fetal shoulders within or above the maternal pelvis. When it occurs, shoulder dystocia is an obstetric emergency.