Program

Nurse-Midwifery M.S.

Year Approved

2022

First Advisor

Vingers, Julie Ann

Second Reader

Katrina Wu

Abstract

Introduction: The purpose of this review is to assess which order of interventions is the most effective and timely at resolving a shoulder dystocia according to the literature. This is important information for perinatal providers to utilize while managing a shoulder dystocia, as there is inconsistency in the literature about what the most effective approach is for resolving this emergency. This review is important to see what the literature shows are the most safe and effective maneuvers for perinatal providers to utilize earlier in the management of shoulder dystocia. Methods: A literature search was conducted to identify original studies published between 2010 and 2021 in CINAHL, PubMed, Science Direct, and Scopus using keywords associated with shoulder dystocia management. Inclusion criteria specified original studies that addressed the management of shoulder dystocia via maneuvers or interventions by obstetric providers. Publications were excluded if they were a literature review, not available in English or full text, addressed prevention of or risk factors for shoulder dystocia, and simulations of shoulder dystocia. Results: The search identified 15 publications that met all criteria. Findings across these studies showed the use of McRobert’s maneuver and suprapubic pressure as the first line maneuvers employed during a shoulder dystocia. Many of the studies recommended the delivery of the posterior arm as the second maneuver. The studies in this review determined there is not a statistical significance in the rate of maternal and neonatal injury based on the obstetric maneuver performed after adjusting for duration of dystocia. Findings across the studies revealed the risk for maternal and neonatal morbidity increased with the number of obstetrical maneuvers performed. Discussion: During a shoulder dystocia, McRobert’s maneuver and suprapubic pressure should be utilized as the first maneuvers as they are simple and effective. If these maneuvers are unsuccessful, the obstetric provider should attempt delivery of the posterior arm. The provider should elicit maneuvers effectively and efficiently in an attempt to reduce the number of maneuvers employed.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis

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