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Management of shoulder dystocia
S B Drummond1, J P Bruner, G W Reed
1Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, USA.
Tennessee Medicine : Journal of the Tennessee Medical Association
|September 22, 2000
Summary
Physicians commonly manage shoulder dystocia with episiotomy, McRoberts maneuver, and suprapubic pressure. However, the all-fours (Gaskin) maneuver is rarely used, indicating a need for further education on shoulder dystocia management techniques.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
Background:
- Shoulder dystocia is a significant obstetric emergency with potential for severe neonatal and maternal morbidity.
- Current management strategies vary among practitioners, impacting clinical outcomes.
Purpose of the Study:
- To assess the current management practices for shoulder dystocia among physicians in Middle Tennessee.
- To determine the utilization rate of the all-fours (Gaskin) maneuver in clinical settings.
Main Methods:
- A survey questionnaire was distributed to physicians in the Middle Tennessee region.
- Physicians were presented with specific clinical scenarios to evaluate their management approaches to shoulder dystocia.
Main Results:
- Episiotomy, McRoberts maneuver, and suprapubic pressure were the most frequently reported management techniques.
- Only 8% of surveyed practitioners reported knowledge and use of the all-fours (Gaskin) maneuver.
- A notable percentage (24%) of practitioners listed more than four management options.
Conclusions:
- There is a low reported utilization of the all-fours (Gaskin) maneuver for shoulder dystocia management.
- Educational initiatives are recommended to increase awareness and adoption of diverse shoulder dystocia management techniques.
