The ABC of shoulder dystocia management.

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.