ACOG: Shoulder Shrug Maneuver to Facilitate Delivery During Shoulder Dystocia


BACKGROUND: Shoulder dystocia is a potential complication of vaginal delivery that increases the chances of injury to the neonate and the mother. The incidence of dystocia can be up to 3%, and sudden presentation and the lack of reliable predictors make shoulder dystocia a challenge for obstetricians.

TECHNIQUE: The shoulder shrug technique involves shrugging the posterior shoulder and rotating the head–shoulder unit 180 degrees to resolve the shoulder dystocia.

EXPERIENCE: We describe successful delivery in three cases of persistent shoulder dystocia using the shoulder shrug technique after the dystocia could not be resolved with McRoberts maneuver.

CONCLUSION: When successful, the shoulder shrug maneuver may decrease the likelihood of morbidity for the neonate. The technique has resolved dystocia in three cases in which the posterior shoulder could be shrugged. Because it does not take much time to perform the shoulder shrug maneuver, it is worth considering this technique during management of unresolved shoulder dystocia.


Reference: Sancetta, Ronald, MD; Khanzada, Hiba, MS; Leante, Ricardo, MS. Shoulder Shrug Maneuver to Facilitate Delivery During Shoulder Dystocia. American College of Obstetrics & Gynecology, May 2019. DOI: 10.1097/AOG.0000000000003278