A 25-year-old G2P1 at 39 weeks is in labor. She has a history of shoulder dystocia in her previous delivery. The current estimated fetal weight is 3.8 kg. Which of the following is the most appropriate management?

• A Elective cesarean section
• B Induction at 39 weeks
• C Perform prophylactic forceps
• D Allow trial of labor with precautions ✓

Explanation

A history of shoulder dystocia is not an absolute indication for cesarean section. A trial of labor is allowed with readiness to perform shoulder dystocia maneuvers. Elective cesarean is considered only if the estimated fetal weight exceeds 4.5 kg in diabetic mothers or 5 kg in non-diabetic mothers. Induction or prophylactic forceps does not prevent shoulder dystocia.

Reference: Dutta's Textbook of Obstetrics, 9th ed.

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Written and medically reviewed by the StethoPrep medical team.