During shoulder dystocia, which manoeuvre involves suprapubic (not fundal) pressure combined with maternal McRobert's position and is the FIRST-LINE intervention?
- A Woods screw manoeuvre
- B McRobert's position with suprapubic pressure ✓
- C Rubin II manoeuvre
- D Gaskin (all-fours) manoeuvre
Correct answer: B. McRobert's position with suprapubic pressure
Explanation
The first-line management of shoulder dystocia is the combination of McRobert's position (hyperflexion of maternal thighs onto abdomen, flattening lumbar lordosis) with continuous suprapubic pressure applied downward by an assistant. This dislodges the impacted anterior shoulder in 40–50% of cases. Fundal pressure is contraindicated as it worsens impaction. Rotational manoeuvres (Woods, Rubin II) are second-line steps.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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