In shoulder dystocia, the McRoberts manoeuvre combined with suprapubic pressure is applied first. If unsuccessful, the next step in the HELPERR mnemonic involves internal rotation. Which manoeuvre involves rotating the fetus by pressure on the posterior aspect of the anterior shoulder to rotate the fetal trunk?

• A Woods screw manoeuvre
• B Gaskin manoeuvre
• C Zavanelli manoeuvre
• D Rubin II manoeuvre ✓

Explanation

In shoulder dystocia management, the Rubin II manoeuvre involves applying pressure to the posterior aspect of the anterior shoulder to adduct and rotate it toward the fetal chest, reducing the shoulder-to-shoulder diameter. The Woods screw manoeuvre rotates the posterior shoulder anteriorly (screw motion). Gaskin manoeuvre is the all-fours position. Zavanelli involves cephalic replacement before caesarean section — a last resort.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.