O'Shaughnessy M J
Department of Obstetrics and Gynecology, University Medical Center, University of California School of Medicine, San Francisco, USA.
Obstet Gynecol. 1998 Oct;92(4 Pt 2):693-5. doi: 10.1016/s0029-7844(98)00153-7.
Shoulder dystocia is an obstetric emergency that can be resolved usually with one or a series of maneuvers performed vaginally. On rare occasions these maneuvers may fail, and the obstetrician must employ less familiar techniques to achieve delivery.
A 30-year-old, gravida 6, developed a severe shoulder dystocia while delivering a 5970 g infant. Classical vaginal maneuvers failed due to the severity of the impaction. After general anesthesia was induced, additional maneuvers such as cephalic replacement and transabdominal rotation also failed. The dystocia was resolved ultimately by a transabdominally-facilitated vaginal posterior arm delivery followed by transabdominal shoulder rotation and vaginal extraction.
In catastrophic cases of shoulder dystocia, transabdominal performance or facilitation of traditional vaginal maneuvers may lead to resolution.
肩难产是一种产科急症，通常可通过一系列经阴道操作解决。极少数情况下这些操作可能失败，产科医生必须采用不太常用的技术来完成分娩。
一名30岁、孕6产的孕妇，在分娩一名体重5970克的婴儿时发生严重肩难产。由于嵌顿严重，传统阴道操作失败。诱导全身麻醉后，诸如胎头复位和经腹旋转等其他操作也失败了。最终通过经腹辅助阴道后臂娩出，随后经腹旋转肩部并经阴道牵引，解决了难产问题。
在灾难性肩难产病例中，经腹实施或辅助传统阴道操作可能解决问题。
