Final answer:
If Wood's corkscrew maneuver is unsuccessful in managing shoulder dystocia, subsequent actions include the Rubin II maneuver, the Zavanelli maneuver, potentially a symphysiotomy or breaking the fetal clavicle. Decisions are made quickly to reduce complications.
Step-by-step explanation:
If Wood's corkscrew maneuver for shoulder dystocia is unsuccessful, the next step is typically to attempt additional obstetrical maneuvers. These may include the Rubin II or reverse Wood's screw maneuver, where pressure is applied to the anterior shoulder from the inside, trying to rotate the shoulder into an oblique position and free it from behind the pubic symphysis. If these maneuvers do not work, more invasive procedures such as performing a Zavanelli maneuver (replacing the fetal head into the pelvis for a cesarean delivery), a symphysiotomy, or breaking the clavicle may be considered to resolve the dystocia.
It's critical to assess the situation promptly and to keep in constant communication with the delivery team, as the decision to move to more invasive procedures should be made quickly to minimize maternal and fetal risk. Each step taken should be based on the clinical judgment of the obstetrician, the situation at hand, and established protocols for managing shoulder dystocia.