1. Management of Cord Prolapse & Shoulder Dystocia
Eliza Rivera-Mitu, RN, MSN

2. Shoulder Dystocia The turtle sign

3. Shoulder Dystocia Management

4. Shoulder Dystocia Management
Suprapubic Pressure

5. Shoulder Dystocia Management
Wood’s Screw Maneuver – high risk for humeral fx

6. Shoulder Dystocia AOCG Guidelines
1) Call for help - assistants, anesthesiology, pediatrician. Initiate gentle traction of the fetal head at this time. Drain the bladder if distended.
2) Generous episiotomy.
3) Suprapubic pressure with normal downward traction on fetal head.
4) McRoberts maneuver.
Then, if these maneuvers fail,
5) Wood's screw maneuver.
6) Attempt delivery of posterior arm.

7. Cord Prolapse Occult Cord

8. Cord Prolapse True Prolapsed Cord

9. Dealing with perinatal loss