Instrumental delivery is a risk factor for shoulder dystocia. The following signs may help you to anticipate a shoulder dystocia:
- maternal increased BMI
- maternal diabetes
- suspected large baby
- indication – prolonged second stage
- slow delivery of the head, face and chin
- 'turtling' of head against perineum
- lack of restitution.
If you are anticipating a shoulder dystocia, remember to communicate this to the rest of the team so that they are prepared to help with McRoberts manoeuvre/suprapubic pressure.
A neonatalogist should be present.