What is dystocia?
“Dystocia” (difficult or obstructed labor)2 encompasses a variety of concepts, ranging from “abnormally” slow dilation of the cervix or descent of the fetus during active labor3 to entrapment of the fetal shoulders after delivery of the head (“shoulder dystocia,” an obstetric emergency).
How successful is McRoberts maneuver?
McRoberts is not only technically simple to employ, but has been found to alleviate 39% to 42% of shoulder dystocias when used alone. The addition of suprapubic pressure and/or proctoepisiotomy increases success rates to between 54% and 58%. In patients with diabetes, however, success rates are not higher.
What is fetal distress?
Fetal distress is a sign that your baby is not well. It happens when the baby isn’t receiving enough oxygen through the placenta. If it’s not treated, fetal distress can lead to the baby breathing in amniotic fluid containing meconium (poo).
Why is dystocia an emergency?
Shoulder dystocia is an obstetric emergency in which normal traction on the fetal head does not lead to delivery of the shoulders. This can cause neonatal brachial plexus injuries, hypoxia, and maternal trauma, including damage to the bladder, anal sphincter, and rectum, and postpartum hemorrhage.
What is retraction of fetal head?
One characteristic of a minority of shoulder dystocia deliveries is the turtle sign, which involves the appearance and retraction of the baby’s head (analogous to a turtle withdrawing into its shell), and a red, puffy face. This occurs when the baby’s shoulder is obstructed by the maternal pelvis.
Why is Ritgen’s maneuver done?
Ritgen recommended extracting the fetal head by this maneuver between uterine contractions to protect the perineum. In our practice, Ritgen’s maneuver has been used as described in standard textbooks, during a uterine contraction,12 to expedite delivery in cases of abnormal fetal heart rate patterns.
