Graham J M, Blanco J D, Wen T, Magee K P
Department of Obstetrics and Gynecology, Texas Tech University, Lubbock.
Obstet Gynecol. 1992 May;79(5 ( Pt 2)):883-4.
Some obstetricians recommend the Zavanelli maneuver to resolve shoulder dystocia. Descriptions in the literature report an almost automatic ease in performance of the maneuver. We report a case of severe shoulder dystocia in which management with the Zavanelli maneuver and immediate cesarean was extremely difficult. The procedure involved exact reversal of all the cardinal movements of labor, and the delivery required terbutaline, general anesthesia, and added personnel to ensure successful extraction of the fetus. A delivery requiring the Zavanelli maneuver can be difficult to perform and may be worsened by insufficient personnel and inexact reversal of all the cardinal movements of labor.
一些产科医生推荐采用扎瓦内利手法来解决肩难产问题。文献中的描述称该手法实施起来几乎自然而然就能轻松完成。我们报告了一例严重肩难产病例，在此病例中，采用扎瓦内利手法并立即剖宫产的操作极其困难。该操作过程需要精确逆转分娩时的所有主要动作，而且分娩过程需要使用特布他林、全身麻醉，并增加人员以确保成功娩出胎儿。需要采用扎瓦内利手法的分娩操作可能很难实施，而且人员不足以及未能精确逆转分娩时的所有主要动作可能会使情况变得更糟。
