Sandberg E C
Am J Obstet Gynecol. 1985 Jun 15;152(4):479-84. doi: 10.1016/s0002-9378(85)80161-7.
Shoulder dystocia is a perilous complication for the fetus. Suffocation and death are imminent. For the obstetrician, there is insufficient time for consultation. Either he or she is ready with an array of manipulative remedies for sequential application or a disorganized chaos will ensue and chance will determine the outcome. Worthy accoucheurs will have planned for this event and will have selected from the numerous procedures touted for its correction that group he or she intuitively feels will be most effective or, at a minimum, most easily remembered. The Zavanelli maneuver deserves to be on every obstetrician's list. It must occupy a bottom priority, however, until its virtue and applicability, demonstrated to date in but a single case, can be confirmed. All current maneuvers for the treatment of shoulder dystocia are directed to completion of vaginal delivery. The Zavanelli maneuver is predicated on cephalic replacement with subsequent delivery by cesarean section.
肩难产对胎儿来说是一种危险的并发症。窒息和死亡迫在眉睫。对于产科医生来说，没有足够的时间进行会诊。要么他或她准备好一系列可供依次应用的手法补救措施，否则将陷入混乱，结果只能听天由命。优秀的产科医生会为此类情况做好预案，并会从众多号称可用于纠正肩难产的方法中挑选出自己凭直觉认为最有效的一组方法，或者至少是最容易记住的方法。扎瓦内利手法理应列入每位产科医生的清单。然而，它必须排在最后，直到其有效性和适用性（目前仅在一个案例中得到证实）能够得到确认。目前所有治疗肩难产的手法都是为了完成经阴道分娩。扎瓦内利手法的前提是将胎头回纳，随后行剖宫产分娩。
