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CC BY-NC-ND 4.0 · AJP Rep 2020; 10(02): e133-e138
DOI: 10.1055/s-0040-1708498
DOI: 10.1055/s-0040-1708498
Original Article
The Carit Maneuver: A Novel Approach for the Relief of Shoulder Dystocia—A Case Series
Further Information
Publication History
27 April 2019
28 June 2019
Publication Date:
15 April 2020 (online)
Abstract
Objective The main purpose of this article is to describe the technique and mechanism of action of a novel intervention for the relief of shoulder dystocia we are labeling Carit maneuver.
Methods We report a cohort study of eight cases of shoulder dystocia not relieved by the combination of McRobert's maneuver and suprapubic pressure treated with the Carit maneuver. This intervention involves the use of the fetal head and neck as the grasping point of the fetus to exert a ventral rotation of the fetal trunk, reduce the bi-acromial diameter, and deliver the posterior shoulder by passive displacement.
In all these cases, the direction of the original head restitution, direction of exerted rotation, and side and location of delivery of the first shoulder were recorded. Maternal and neonatal outcomes were reviewed and reported.
Results In all cases, the Carit rotational maneuver resulted in the delivery of the posterior shoulder in the transverse (4), oblique anterior (2), or direct anterior (2) diameters. No instances of neonatal depression or fetal acidemia were noted in this cohort.
Conclusion The Carit maneuver is an original and successful intervention in the management of shoulder dystocia unresponsive to McRobert's maneuver and suprapubic pressure.
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References
- 1 Langer O, Berkus MD, Huff RW, Samueloff A. Shoulder dystocia: should the fetus weighing greater than or equal to 4000 grams be delivered by cesarean section?. Am J Obstet Gynecol 1991; 165 (4 Pt 1): 831-837
- 2 Gherman RB, Chauhan S, Ouzounian JG, Lerner H, Gonik B, Goodwin TM. Shoulder dystocia: the unpreventable obstetric emergency with empiric management guidelines. Am J Obstet Gynecol 2006; 195 (03) 657-672
- 3 Committee on Practice Bulletins—Obstetrics. Practice bulletin no 178: shoulder dystocia. Obstet Gynecol 2017; 129 (05) e123-e133 https://journals.lww.com/greenjournal/Abstract/2017/05000/Practice_Bulletin_No_178__Shoulder_Dystocia.47.aspx Accessed January 03 2019
- 4 Chauhan SP, Gherman R, Hendrix NW, Bingham JM, Hayes E. Shoulder dystocia: comparison of the ACOG practice bulletin with another national guideline. Am J Perinatol 2010; 27 (02) 129-136
- 5 Hope P, Breslin S, Lamont L. , et al. Fatal shoulder dystocia: a review of 56 cases reported to the Confidential Enquiry into Stillbirths and Deaths in Infancy. Br J Obstet Gynaecol 1998; 105 (12) 1256-1261
- 6 Resnik R. Management of shoulder girdle dystocia. Clin Obstet Gynecol 1980; 23 (02) 559-564
- 7 Naef III RW, Martin Jr JN. Emergent management of shoulder dystocia. Obstet Gynecol Clin North Am 1995; 22 (02) 247-259
- 8 Bennett BB. Shoulder dystocia: an obstetric emergency. Obstet Gynecol Clin North Am 1999; 26 (03) 445-458 , viii
- 9 Gherman RB. Shoulder dystocia: prevention and management. Obstet Gynecol Clin North Am 2005; 32 (02) 297-305 , x
- 10 McFarland MB, Langer O, Piper JM, Berkus MD. Perinatal outcome and the type and number of maneuvers in shoulder dystocia. Int J Gynaecol Obstet 1996; 55 (03) 219-224
- 11 Gherman RB, Goodwin TM, Souter I, Neumann K, Ouzounian JG, Paul RH. The McRoberts' maneuver for the alleviation of shoulder dystocia: how successful is it?. Am J Obstet Gynecol 1997; 176 (03) 656-661
- 12 Allen RH. On the mechanical aspects of shoulder dystocia and birth injury. Clin Obstet Gynecol 2007; 50 (03) 607-623
- 13 Woods CE. A principle of physics as applicable to shoulder dystocia. Obstet Gynecol 1943; 45 (05) 796-804
- 14 Mazzanti GA. Delivery of the anterior shoulder; a neglected art. Obstet Gynecol 1959; 13 (05) 603-607
- 15 Shute WB. Management of shoulder dystocia with the Shute parallel forceps. Am J Obstet Gynecol 1962; 84: 936-939
- 16 Heery RD. A method to relieve shoulder dystocia in vertex presentation. Obstet Gynecol 1963; 22: 360-361
- 17 Rubin A. Management of shoulder dystocia. JAMA 1964; 189: 835-837
- 18 Hibbard LT. Shoulder dystocia. Obstet Gynecol 1969; 34 (03) 424-429
- 19 Chavis WM. A new instrument for the management of shoulder dystocia. Int J Gynaecol Obstet 1978; -1979–1979 16 (04) 331-332
- 20 Sandberg EC. The Zavanelli maneuver: a potentially revolutionary method for the resolution of shoulder dystocia. Am J Obstet Gynecol 1985; 152 (04) 479-484
- 21 Meenan AL, Gaskin IM, Hunt P, Ball CA. A new (old) maneuver for the management of shoulder dystocia. J Fam Pract 1991; 32 (06) 625-629
- 22 Goodwin TM, Banks E, Millar LK, Phelan JP. Catastrophic shoulder dystocia and emergency symphysiotomy. Am J Obstet Gynecol 1997; 177 (02) 463-464
- 23 O'Leary JA, Cuva A. Abdominal rescue after failed cephalic replacement. Obstet Gynecol 1992; 80 (3 Pt 2): 514-516
- 24 O'Shaughnessy MJ. Hysterotomy facilitation of the vaginal delivery of the posterior arm in a case of severe shoulder dystocia. Obstet Gynecol 1998; 92 (4 Pt 2): 693-695
- 25 Beer E. History of extraction of the posterior arm to resolve shoulder dystocia. Obstet Gynecol Surv 2006; 61 (03) 149-151
- 26 ACOG Committee on Practice Bulletins-Gynecology, The American College of Obstetrician and Gynecologists. ACOG practice bulletin clinical management guidelines for obstetrician-gynecologists. Number 40, November 2002. Obstet Gynecol 2002; 100 (5 Pt 1): 1045-1050
- 27 Royal College Obstetricians and Gynecologists. . Shoulder dystocia. Green-Top Guideline No. 42. RCOG 2012 . Available at: https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_42.pdf . Accessed January 03, 2019.
- 28 Hoffman MK, Bailit JL, Branch DW. , et al; Consortium on Safe Labor. A comparison of obstetric maneuvers for the acute management of shoulder dystocia. Obstet Gynecol 2011; 117 (06) 1272-1278
- 29 Poggi SH, Spong CY, Allen RH. Prioritizing posterior arm delivery during severe shoulder dystocia. Obstet Gynecol 2003; 101 (5 Pt 2): 1068-1072
- 30 Gold S, Hirsch D, Schutzman D, Cohen A, Jaspan D, Goldberg J. Delivery of the posterior arm as initial maneuver to relieve shoulder dystocia increased neonatal humeral fractures. . [24D] Obstet Gynecol 2018; 131 (05) 47s
- 31 Cusick W, Cox RL, Santos P, Hefele JG, Darden J. Shoulder dystocia response: improving neonatal outcomes. . [658] Am J Obstet Gynecol 2017; 216 (01) 386s
- 32 Sienas LE, Hedriana HL, Wiesner S, Pelletreau B, Wilson MD, Shields LE. Decreased rates of shoulder dystocia and brachial plexus injury via an evidence-based practice bundle. Int J Gynaecol Obstet 2017; 136 (02) 162-167
- 33 Gurewitsch Allen ED, Brown Will SE, Allen RH, Satin AJ. Targeted training effort improves shoulder dystocia management and outcomes. Am J Obstet Gynecol 2017; 216 (01) 517s
- 34 Morris WIC. Shoulder dystocia. J Obstet Gynaecol Br Emp 1955; 62: 302-306
- 35 Gross SJ, Shime J, Farine D. Shoulder dystocia: predictors and outcome. A five-year review. Am J Obstet Gynecol 1987; 156 (02) 334-336