The measure which is done to manage shoulder dystocia?

Appeared in: KPSC Staff Nurse - 2018

Explanation

McRobert's maneuver is a primary, non-invasive intervention for shoulder dystocia, an obstetric emergency where the baby's shoulder gets stuck behind the mother's pubic bone after the head is delivered.
The maneuver involves hyperflexing the mother's thighs up onto her abdomen.
This action straightens the lumbosacral angle and rotates the symphysis pubis, which alters the pelvic angle and often releases the impacted anterior shoulder.
It is one of the first and most effective maneuvers attempted, often used in conjunction with suprapubic pressure.

Option A: The Burns Marshall maneuver is not used for shoulder dystocia.
Option B: The Lovset maneuver is not indicated for shoulder dystocia.
Option C: The Mauriceau-Smellie-Viet maneuver is unrelated to shoulder dystocia.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Management of Shoulder Dystocia as background academic context rather than a clinical decision trigger.
Shoulder dystocia is an unpredictable obstetric emergency that requires immediate, coordinated action to prevent fetal hypoxia, brachial plexus injury, or death.
Nurses are critical in recognizing the 'turtle sign' (retraction of the fetal head against the perineum), immediately calling for help, and assisting with positioning for the McRobert's maneuver and applying suprapubic pressure.
It is vital to avoid fundal pressure, as this can worsen the impaction of the shoulder.

How to Approach the Question

First, identify the core clinical problem presented in the question, which is 'shoulder dystocia'.
Recall the standard management protocols and maneuvers specifically for this obstetric emergency.
Evaluate each option to determine its correct clinical indication.
Recognize that McRobert's maneuver is a well-established, first-line treatment for shoulder dystocia.
Differentiate this from the other options (Burns Marshall, Lovset, Mauriceau-Smellie-Viet), which are all associated with managing complications of a breech presentation, not a shoulder dystocia in a cephalic presentation.
Select the option that directly addresses the problem of an impacted shoulder after the head has been delivered.

Concept Tested & Keywords

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur pp. 17-25, 18-26

E6 Obstetrics Williams p. 7-17

Practise the full KPSC Staff Nurse - 2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.