In managing shoulder dystocia, which maneuver involves suprapubic pressure combined with flexion-abduction-external rotation of the posterior fetal hip to decrease the shoulder circumference and deliver the posterior arm?

• A Woods screw maneuver ✓
• B McRoberts maneuver
• C Rubin II maneuver
• D Gaskin maneuver (all-fours)

Explanation

The Woods screw maneuver involves applying pressure to the anterior surface of the posterior shoulder (Rubin II applies pressure to the posterior surface of the anterior shoulder) to rotate the fetus like a screw and deliver the impacted anterior shoulder. Combined with Rubin II (double Woods or Rubin-Woods), both shoulders are rotated. McRoberts involves maternal thigh hyperflexion; Gaskin involves the all-fours position to leverage sacral mobility. The initial management is McRoberts + suprapubic pressure, then internal maneuvers.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.