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Svetlana Frandsen1, Pernille Ravn1

  • 1Gynækologisk Obstetrisk Afdeling, Odense Universitetshospital.

Ugeskrift for Laeger
|June 21, 2024
PubMed
Summary

Severe shoulder dystocia, a dangerous delivery complication, can be life-threatening for infants. The rare Zavanelli maneuver, involving head repositioning for C-section, failed in a case report, resulting in vaginal delivery of a stillborn infant.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatology
  • Maternal-Fetal Medicine

Background:

  • Shoulder dystocia is a critical obstetric emergency where fetal shoulders become impacted after head delivery during vaginal birth.
  • Prompt obstetric maneuvers are essential for managing shoulder dystocia to prevent fetal injury or demise.
  • The Zavanelli maneuver, a rare abdominal approach, involves cephalic replacement followed by cesarean delivery.

Observation:

  • A case report details a 26-year-old woman experiencing severe shoulder dystocia.
  • The Zavanelli maneuver was attempted but ultimately failed to facilitate delivery.
  • The delivery concluded vaginally, unfortunately resulting in a stillborn infant.

Findings:

  • The Zavanelli maneuver, despite its rarity, proved unsuccessful in resolving severe shoulder dystocia in this case.
  • The case highlights the potential risks and limitations associated with the Zavanelli maneuver.
  • Failure to resolve shoulder dystocia led to a tragic outcome despite intervention.

Implications:

  • This case underscores the critical need for experienced management of shoulder dystocia and its potential complications.
  • It emphasizes the limitations of the Zavanelli maneuver and the importance of alternative strategies.
  • Further research into effective management of intractable shoulder dystocia is warranted to improve fetal outcomes.

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