Key result
The Carit maneuver successfully resulted in the delivery of the posterior shoulder in all 8 cases of shoulder dystocia unresponsive to standard maneuvers, with no neonatal depression or fetal acidemia.
Why the study?
The authors sought to describe the technique and mechanism of action of a novel intervention, the Carit maneuver, for the relief of shoulder dystocia.
Does the Carit maneuver relieve shoulder dystocia unresponsive to McRobert's maneuver and suprapubic pressure?
Cohort (n=8)
Does the Carit maneuver relieve shoulder dystocia unresponsive to McRobert's maneuver and suprapubic pressure?
The Carit maneuver appears to be a successful novel intervention for managing shoulder dystocia unresponsive to standard initial maneuvers.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for the Carit maneuver in refractory shoulder dystocia; prospective validation required before clinical adoption.
Objective The main purpose of this article is to describe the technique and mechanism of action of a novel intervention for the relief of shoulder dystocia we are labeling Carit maneuver. Methods We report a cohort study of eight cases of shoulder dystocia not relieved by the combination of McRobert's maneuver and suprapubic pressure treated with the Carit maneuver. This intervention involves the use of the fetal head and neck as the grasping point of the fetus to exert a ventral rotation of the fetal trunk, reduce the bi-acromial diameter, and deliver the posterior shoulder by passive displacement. In all these cases, the direction of the original head restitution, direction of exerted rotation, and side and location of delivery of the first shoulder were recorded. Maternal and neonatal outcomes were reviewed and reported. Results In all cases, the Carit rotational maneuver resulted in the delivery of the posterior shoulder in the transverse (4), oblique anterior (2), or direct anterior (2) diameters. No instances of neonatal depression or fetal acidemia were noted in this cohort. Conclusion The Carit maneuver is an original and successful intervention in the management of shoulder dystocia unresponsive to McRobert's maneuver and suprapubic pressure.
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Gei et al. (2020) conducted a cohort in Shoulder dystocia (n=8). Carit maneuver was evaluated on Delivery of the posterior shoulder. The Carit maneuver successfully resulted in the delivery of the posterior shoulder in all 8 cases of shoulder dystocia unresponsive to standard maneuvers, with no neonatal depression or fetal acidemia.
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