Lurie S, Ben-Arie A, Hagay Z
Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel.
Asia Oceania J Obstet Gynaecol. 1994 Jun;20(2):195-7. doi: 10.1111/j.1447-0756.1994.tb00449.x.
In this retrospective study we analyzed our experience in management of 76 consecutive cases of shoulder dystocia. In most cases (N = 67, 88.2%) McRoberts' maneuver was sufficient in order to deliver the impacted shoulders. In 2 cases (2.6%) in addition to McRoberts' maneuver suprapubic pressure was applied. In 7 cases (9.2%) Woods' maneuver was performed after the McRoberts' maneuver and the suprapubic pressure. Based on our experience and upon careful review of the literature we propose the optimal "ABC" for the management of shoulder dystocia. It includes A) McRoberts' maneuver, B) Suprapubic pressure, C) Woods' maneuver, D) Delivery of posterior arm. We emphasize that the shoulder dystocia situation is a major emergency in obstetrics and that its management requires prompt resuscitation of the fetus during the process of its delivery.
在这项回顾性研究中，我们分析了连续处理76例肩难产病例的经验。在大多数病例（N = 67，88.2%）中，麦罗伯茨手法足以娩出嵌顿的肩部。2例（2.6%）除采用麦罗伯茨手法外，还施加了耻骨上按压。7例（9.2%）在麦罗伯茨手法和耻骨上按压后进行了伍兹手法。基于我们的经验并仔细查阅文献，我们提出了处理肩难产的最佳“ABC”方案。它包括A）麦罗伯茨手法，B）耻骨上按压，C）伍兹手法，D）娩出后臂。我们强调，肩难产情况是产科的重大紧急情况，其处理需要在胎儿娩出过程中迅速对胎儿进行复苏。
