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Shoulder dystocia — DIPIMC MCQ

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ModeratePaediatric and Obstetric EmergenciesShoulder dystociaDIPIMCDipIMC

During an out-of-hospital delivery, the baby's head delivers but then retracts tightly against the perineum, and the shoulders do not deliver with the next contraction. What is the most appropriate first manoeuvre?

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

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Correct answer: E — Place the mother in the McRoberts position and apply suprapubic pressure

Shoulder dystocia is managed first with the McRoberts manoeuvre (hyperflexing the mother's hips onto the abdomen) combined with suprapubic pressure, which resolves most cases. Strong traction on the head and fundal pressure risk brachial plexus injury and further impaction. Sitting upright does not address the obstruction at the pelvic inlet. Pearl: call urgently for help early and be ready to progress to internal manoeuvres if McRoberts and suprapubic pressure fail.

Reference: MBRRACE-UK; APLS