Shoulder Dystocia

SHOULDER DYSTOCIA MNEMONIC

International

Ask for help

Lift - the buttocks
- the legs
} McRoberts Maneuver
Anterior disimpaction
- rotate to oblique
- suprapubic pressure
Rotate the posterior shoulder - Woods maneuver
Manual removal of the posterior arm
Episiotomy consider
Roll over
 S Mnemonic
Shoulder
POST Dystocia
PARTUM HEMORRHAGE
International MNEMONIC
Mnemonic
H Help. Ask for Help
A Assess (vital sign, blood loss) and resucitate
Establish aetilogy, ensure aviabioity of blood, acbolic Initial Management
E
(oxytocin, ergometrine, or syntometrine bolus IV/IM)
M Massage uterus
Oxytocin infusion, ergometrine bolus IV/IM, prostaglandins
O Medical Treatment
per rectal
Shift to the theatre. Exclude retain products and trauma,
S Conservative Non
bimanual compression, abdominal aorta compression
Surgical Management
T Tamponade ballon and uterine packing
A Apply compression uterus, B-Lynch technique or modified
Systemic pelvic devascularization : uterine, ovarian, quadriple,
S Conservative Surgical
internal iliaca, Lasso-Budiman technique
Management
Interventional radiologist, if appropriate, uterine artery
I
embolization
Last Effort- Non -
S Subtotal/total hysterectomy Conservative Surgical
Management