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Shoulder dystocia — maternity emergency 🚨 🤰
Shoulder dystocia — maternity emergency 🚨 🤰
After the fetal head delivers, the shoulder may impact behind the maternal pelvis, creating an immediately time-critical birth emergency.
🔎 Recognise
Recognise failure of the shoulders to deliver with routine gentle axial traction, including the possible turtle sign. Prediction by fetal size is unreliable.
🛟 First actions
Call the obstetric emergency team immediately and announce shoulder dystocia. The trained maternity team performs a systematic sequence of positioning and specialised manoeuvres; summon neonatal help.
🧪 Investigations and reassessment
Document the event, exact timing, personnel, manoeuvres and neonatal assessment. Observe for maternal haemorrhage or trauma and neonatal brachial plexus or skeletal injury.
⚠️ Common pitfalls and escalation
Do not apply fundal pressure or excessive downward traction. Practical manoeuvres require recurrent simulation and competent senior obstetric supervision, not reading this card alone.
UK reference: RCOG Green-top 42. Focused editorial source check, 7 November 2026; this is not independent clinical or pharmacy sign-off. Verify current local policy, BNF/BNFC and specialist advice before treatment. Not a prescribing protocol.
Related guides: Postpartum haemorrhage — FY quick guide 🚨 🩸 · Eclampsia or severe pre-eclampsia 🚨 🤰
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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