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All-fours maneuver for reducing shoulder dystocia during labor
J P Bruner1, S B Drummond, A L Meenan
1Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN 37232-2519, USA.
The Journal of Reproductive Medicine
|June 4, 1998
Summary
The all-fours maneuver is a safe and effective technique for managing shoulder dystocia, with most deliveries requiring no additional interventions. This method significantly reduces complications in laboring women.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Maternal-Fetal Medicine
Background:
- Shoulder dystocia is a significant obstetric emergency.
- Effective management techniques are crucial for improving outcomes.
Purpose of the Study:
- To evaluate the clinical experience and effectiveness of the all-fours maneuver for shoulder dystocia management.
- To assess maternal and neonatal morbidity associated with this technique.
Main Methods:
- Retrospective review of 82 consecutive shoulder dystocia cases managed with the all-fours maneuver.
- Data collected on delivery outcomes, maternal, and neonatal complications.
Main Results:
- The all-fours maneuver was used in 1.8% of deliveries, with 83% requiring no additional interventions.
- The mean diagnosis-to-delivery interval was 2.3 minutes.
- Maternal and perinatal mortality were zero; morbidity was low (1.2% maternal, 4.9% neonatal) and associated with higher birth weights.
Conclusions:
- The all-fours maneuver is a rapid, safe, and effective technique for managing shoulder dystocia.
- It appears to reduce the need for additional interventions and associated complications.