Shoulder Dystocia

Shoulder dystocia occurs when a vaginal delivery is complicated by failure of progression of labor due to the anterior shoulder of the fetus not passing from behind the maternal pubic symphysis. If a patient is progressing in active labor to the emergency department, there is no way to have predicted this complication of pregnancy. However, shoulder dystocia must be recognized immediately during labor and managed appropriately to prevent assorted injury to the mother or baby. There are a series of maneuvers and interventions where an emergency physician must be familiar with to optimize maternal and fetal outcomes.