The Zavanelli manoeuvre is a last-resort procedure in which of the following obstetric emergencies?
- A Intractable shoulder dystocia after all other manoeuvres have failed ✓
- B Cord prolapse after full dilatation
- C Uterine inversion occurring after third-stage mismanagement
- D Vasa praevia with acute fetal haemorrhage
Correct answer: A. Intractable shoulder dystocia after all other manoeuvres have failed
Explanation
The Zavanelli manoeuvre involves cephalic replacement — manually replacing the delivered fetal head back into the vagina and performing an emergency caesarean section. It is reserved for intractable shoulder dystocia when all other manoeuvres (McRoberts, suprapubic pressure, Rubin, Woods, posterior arm delivery, Gaskin all-fours) have failed. It carries risks of uterine rupture and significant fetal morbidity.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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