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Shoulder dystocia — DipIMC MCQ

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ModeratePaediatric and Obstetric EmergenciesShoulder dystociaDipIMC

A home birth is complicated after the fetal head delivers but the shoulders do not. The midwife reports turtle-neck sign and the mother is exhausted. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Call for urgent obstetric help and perform McRoberts positioning with suprapubic pressure

Option D is correct because Shoulder dystocia requires immediate help, McRoberts manoeuvre and suprapubic pressure as first-line measures. Option E is less appropriate because oxygen may be supportive, but it does not address the defining time-critical problem first; option B is less appropriate because vascular access is useful, but it should not delay the immediate priority. Option A is less appropriate because it is plausible in a different scenario but suboptimal for the features described; option C is less appropriate because delay would increase clinical risk. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: JRCALC Guidelines; Resuscitation Council UK; PROMPT principles