Question

(5) nursing care plan for shoulder dystocia ?

Answer 1

Shoulder Dystocia is an obstetric maneuvers to deliver fetus where head has been delivered but failed to deliver the shoulder appropriately resulting breakage of clavicle or humerus or brachial plexus got ruptured.

Risk factors - diabetes , obesity , prolonged first or second stage labor , postmaturity , multiparity etc .

Nursing care -

Perinatal nurse should guide and advice mother about optimum weight gain during pregnancy . And for diabetes female, nurse should teach about control of hyperglycaemia and proper diet and medication to be taken to prevent risk of shoulder dystocia .

During early labor phase , nurse should teach about maneuver and position during labor .

During labor , nurse should assist maneuver and applies suprapubic pressure slightly towards side if fetal chest . This will reduce biacromial diameter and rotate anterior shoulder toward oblique diameter .

Some maneuver used in shoulder dystocia and asssisted by nurse are :-

1- McRoberts maneuver

2- Wood's maneuver

3- extraction of posterior arm

Zavanelli maneuver or symphysiotomy is done rarely .