|October 2007 · Vol. 19, No. 10
Shoulder dystocia: Clarifying the care of an old problem
Should maternal pushing stop once dystocia is diagnosed? Here’s light on the standard of care.
Erb’s palsy was associated with rapid delivery and unusually forceful expulsive effort in one third of cases
When the “turtle sign” is present, avoid encouraging maternal pushing, and simply support and guide the head without supplying any real traction
Dr. Goldstein is Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.
The author reports no financial relationships relevant to this article.
Brachial plexus injury is a dreaded sequela of shoulder dystocia, one that lies at the root of many medical liability disputes. Although brachial plexus injury cannot be prevented, most of the commonly used maneuvers for freeing a stuck shoulder are designed to maximize fetal safety and minimize injury.