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Shoulder dystocia — RCPSC EM MCQ

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ModerateOB/GYN emergenciesShoulder dystociaRCPSC EM

A 30-year-old at 39 weeks delivers precipitously in the ED. The fetal head delivers but retracts against the perineum and gentle downward traction does not deliver the anterior shoulder. Fetal heart rate is 90. What is the most likely diagnosis?

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Correct answer: B — Shoulder dystocia

Turtle sign and failure of shoulder delivery after the head indicates shoulder dystocia, requiring immediate manoeuvres and team coordination.

Reference: SOGC Guideline No. 414 pregnancy of unknown location and ectopic pregnancy