Key result
Posterior arm delivery resolves shoulder dystocia, causing a humerus fracture that heals within 3 weeks.
Case Report (n=1)
Highlights the importance of immediate and skilful intervention in rare cases of shoulder dystocia, even in average-weight fetuses without risk factors.
Skilled posterior arm delivery may aid shoulder dystocia resolution; case reports leave open prospective safety data on fracture risk.
Shoulder dystocia is a critical obstetrical emergency that challenges even the most experienced practitioners. This case report details a patient at 40 weeks of gestation with no identified risk factors. Following the delivery of the head, the baby’s shoulders became lodged behind the maternal pubis and did not deliver despite gentle downward traction, raising suspicion of shoulder dystocia. Various manoeuvres were attempted, and ultimately, the posterior arm was delivered by sweeping through the corresponding antecubital fossa, resulting in the successful birth of a live 3.4 kg baby. However, the posterior arm’s humerus sustained a fracture during delivery. With appropriate treatment, the term neonate recovered fully, exhibiting a full range of movement in the affected limb, and the fracture healed within 3 weeks. Although shoulder dystocia is rare, it necessitates immediate and skilful intervention. Therefore, all obstetricians should undergo simulation training and master all relevant manoeuvres.
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Yaliwal et al. (2024) conducted a case report in Shoulder dystocia (n=1). Delivery manoeuvres including sweeping the posterior arm through the antecubital fossa was evaluated on Resolution of shoulder dystocia and neonatal outcome. Delivery of the posterior arm resolved shoulder dystocia in an average-weight fetus, resulting in a humerus fracture that fully healed within 3 weeks with appropriate treatment.
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