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Shoulder dystocia — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesShoulder dystociaDipIMC

A term baby is delivered unexpectedly at home and the head has delivered but retracts against the perineum. The mother is on the floor and contractions continue. What is the most appropriate management?

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

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Correct answer: E — Call for urgent obstetric help, perform McRoberts positioning and apply suprapubic pressure

Call for urgent obstetric help, perform McRoberts positioning and apply suprapubic pressure is the best answer because shoulder dystocia is managed initially with maternal repositioning and suprapubic pressure while summoning help. Provide reassurance and reassess after transport is less appropriate because reassurance is inadequate for an evolving major trauma problem; Give unrestricted crystalloid to normalise blood pressure is less appropriate because over-resuscitation can worsen bleeding when haemorrhage is uncontrolled. Use oral analgesia as the main treatment and Defer treatment until a senior hospital doctor reviews the patient are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; RCOG Shoulder Dystocia guidance