1. (d) Perform a generous episiotomy or episioproctotomy. Thisp.234-243. (2nd edition),McGraw-Hill: New York, 1992. alone will suffice to solve the problem in many sit- 2. Roseveas SK, Stirrat GM. Handbook of Obstetric Management, uations. It will also give adequate room to insert the pp. 251. Blackwell Science: Oxford, 1996. fingers posteriorily to effect the next maneuver. 3. Papp Z. A Szülészet-Nögyógyászat Tankönyve, p. 432. Semmel
2. (g) Unless the anterior shoulder has been freed, there edition). WB Saunders Co: Philadelphia, 1999. should be no attempt to use traction upon the head in 10.Hardy AE. Birth injuries of the brachial plexus. J Bone Joint Surg an attempt to release the shoulder. Once it is released, 1981; 63: 98-101. care must be taken to support the posterior aspect of the 11. Hopwood HG. Shoulder dystocia: fifteen years' experience in a head with mild traction at an angle not to exceed 30º community hospital. Am J Obstet Gynecol 1982; 144: 162-6. or, preferably, by pulsion from above made upon the 12. Gross TL, Sokol RJ, Williams T et al. Shoulder dystocia: a infant's mandible and neck. fetal-physician risk. Am J Obstet Gynecol 1987; 156: 1408-18.
3. Is maternal obesity a predictor of shoulder dystocia?