Question

What is the correct order of maneuvers in shoulder dystocia?

• A. McRoberts $\rightarrow$ Rubin $\rightarrow$ Gaskin $\rightarrow$ Zavanelli
• B. Zavanelli $\rightarrow$ McRoberts $\rightarrow$ Gaskin $\rightarrow$ Rubin
• C. Rubin $\rightarrow$ Gaskin $\rightarrow$ McRoberts $\rightarrow$ Zavanelli
• D. McRoberts $\rightarrow$ Suprapubic pressure $\rightarrow$ Rubin $\rightarrow$ Zavanelli

Hint:

In shoulder dystocia, remember: McRoberts first, Zavanelli last.

Answer 1

The Correct Option is A

Concept: Shoulder dystocia is an obstetric emergency. Management begins with simple maneuvers and progresses to more advanced maneuvers if needed.

Step 1: Start with the first-line maneuver.
The first maneuver is usually: \[ \text{McRoberts maneuver} \] It involves hyperflexion and abduction of the mother's thighs.

Step 2: Move to internal rotation maneuvers.
If McRoberts fails, internal maneuvers such as Rubin maneuver can be tried.

Step 3: Use advanced maneuvers later.
Gaskin maneuver and Zavanelli maneuver are later options, with Zavanelli being a last-resort maneuver. Therefore, the best sequence among the options is McRoberts $\rightarrow$ Rubin $\rightarrow$ Gaskin $\rightarrow$ Zavanelli.