What is the typical management strategy for managing shoulder dystocia?

The typical management strategy for shoulder dystocia involves the McRoberts maneuver and suprapubic pressure. The McRoberts maneuver is a simple yet effective technique that involves hyperflexing the mother's legs towards her abdomen. This position dramatically alters the pelvic geometry and helps to widen the pelvic outlet, potentially allowing the impacted shoulder to slip past the pubic symphysis.

In addition, applying suprapubic pressure involves pushing down, just above the pubic bone, to assist in dislodging the anterior shoulder from behind the symphysis pubis. This combination of maneuvers is generally the first-line approach in managing shoulder dystocia and is often successful in resolving the situation without the need for more invasive interventions.

While cesarean delivery is a possible course of action if the dystocia cannot be resolved, it is not the immediate first step in an acute setting where the goal is to deliver the baby vaginally. The Zavanelli maneuver, which involves pushing the fetal head back into the vagina to perform a cesarean delivery, is rarely used due to its complexity and risks. Forceps delivery is also less commonly indicated in shoulder dystocia as it can increase the risk of injury or complications. The primary focus is generally on non-invasive techniques