Shoulder dystocia — MCCQE Part 1 MCQ

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ModeratePregnancyShoulder dystociaMCCQE Part 1

During delivery, the fetal head delivers but retracts against the perineum and gentle traction does not deliver the shoulders. Which of the following is the most appropriate next step?

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Correct answer: C — Call for help and perform McRoberts manoeuvre with suprapubic pressure

Call for help and perform McRoberts manoeuvre with suprapubic pressure is the single best answer because the age, timing, examination findings and investigations in the vignette fit Shoulder dystocia better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to SOGC shoulder dystocia guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: SOGC shoulder dystocia guidance