Advanced Life Support in Obstetrics (ALSO): Shoulder Dystocia

Chapter I in the Advanced Life Support in Obstetrics (ALSO) Course Manual, March 2012, is an outstanding treatise on the science behind the management of shoulder dystocia and also features an outstanding practical algorithm for its management. 

And another great resource is Shoulder Dystocia Delivery, Manoeuvres, Management, Simulation on YouTube, published July 7, 2012, 5:43 by (an outstanding charity worth visiting and supporting, I think). This video follows the sequence detailed in The Advanced Life Support In Obstetrics Chapter I, March 2012, using the “HELPERR” mneumonic.

H – Call for Help

E – Evaluate for Epiosotomy

L – Legs (McRoberts Maneuver)

P – Suprapubic Pressure

E – Enter — Internal Rotary Maneuvers

R – Remove the Posterior Arm

R – Roll the Patient

Don’t use fundal pressure, it makes things worse.

See also Steps to overcome shoulder dystocia on YouTube. Published April 3, 2012. The recommended sequence of manuevers of this video is different from that recommended in the Advanced Life Support in Obstetrics Manual. But it shows how you can use an newborn mannequin  with an assistant’s two hands simulating the birth canal so that you can practice the maneuvers for shoulder dystocia.

The key to shoulder dystocia management is to practice as a team on a regular basis with simulators.


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