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Shoulder dystocia — DIPIMC MCQ

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HardPaediatric and Obstetric EmergenciesShoulder dystociaDIPIMCDipIMC

During an unplanned birth, the fetal head delivers then retracts against the perineum and the shoulders do not follow with the next contraction. Which manoeuvre should be attempted first?

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

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Correct answer: D — Use McRoberts positioning together with suprapubic pressure

The best answer is “Use McRoberts positioning together with suprapubic pressure”. Head retraction with failure of shoulder delivery indicates shoulder dystocia. McRoberts positioning hyperflexes the maternal hips and suprapubic pressure helps dislodge the anterior shoulder. Fundal pressure can worsen impaction, and forceful traction risks brachial plexus injury. Further internal manoeuvres are escalations if the initial approach fails, with immediate obstetric and neonatal support requested.

Reference: RCOG, Shoulder dystocia: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/shoulder-dystocia/