Prioritizing posterior arm delivery during severe shoulder dystocia

Sarah H. Poggi, Catherine Y. Spong, Robert H. Allen

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

BACKGROUND: Delivery of the posterior arm, or the Barnum maneuver, is at times used late in shoulder dystocia management algorithms, and is not often a first- or second-line management protocol. CASE: A multiparous, diabetic patient, who was morbidly obese and had a residual obstetric brachial plexus injury, experienced a precipitous second stage of labor and severe shoulder dystocia. Attempts at the McRoberts maneuver with traction failed to deliver the fetus. In lieu of alternative maneuvers or continued attempts at traction, the posterior arm was delivered and the fetal trunk followed easily. CONCLUSION: A geometric analysis reveals that using posterior arm delivery reduces the obstruction by more than a factor of two, relative to the McRoberts maneuver. We recommend earlier use of this maneuver during shoulder dystocia management.

Original languageEnglish (US)
Pages (from-to)1068-1072
Number of pages5
JournalObstetrics and gynecology
Volume101
Issue number5 SUPPL.
DOIs
StatePublished - May 1 2003
Externally publishedYes

Fingerprint

Dystocia
Arm
Traction
Arm Injuries
Second Labor Stage
Brachial Plexus
Obstetrics
Fetus

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Prioritizing posterior arm delivery during severe shoulder dystocia. / Poggi, Sarah H.; Spong, Catherine Y.; Allen, Robert H.

In: Obstetrics and gynecology, Vol. 101, No. 5 SUPPL., 01.05.2003, p. 1068-1072.

Research output: Contribution to journalArticle

Poggi, Sarah H. ; Spong, Catherine Y. ; Allen, Robert H. / Prioritizing posterior arm delivery during severe shoulder dystocia. In: Obstetrics and gynecology. 2003 ; Vol. 101, No. 5 SUPPL. pp. 1068-1072.
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