Final answer:
Shoulder dystocia can arise during the second stage of labor, recognized by the retraction of the infant's head against the perineum. The correct actions include applying suprapubic pressure and performing the McRoberts' maneuver, while avoiding potentially harmful interventions like fundal pressure or incorrect maternal positioning.
Step-by-step explanation:
During the second stage of labor, if the infant's head delivers but the neck does not appear and the chin retracts against the perineum, this is immediately recognized as shoulder dystocia, a serious and potentially harmful situation for both the mother and the baby. Shoulder dystocia occurs when one or both of the baby's shoulders become stuck inside the mother's pelvis after the head has been delivered.
The correct management for shoulder dystocia involves:
- Apply suprapubic pressure to help dislodge the baby's shoulder from behind the pubic bone.
- Perform the McRoberts' maneuver, which involves sharply flexing the mother's thighs up to her abdomen to widen the pelvis and flatten the spine, helping the shoulder to slip out.
- Do not turn the mother on her side or apply fundal pressure as these actions can worsen the shoulder dystocia and cause additional complications.
- Do not place the mother on her hands and knees and elevate the presenting part without proper training and indication as it may not be effective and can delay other necessary interventions.
Administering oxygen at 10Lpm via face mask and raising the head of the bed may also be beneficial to support maternal oxygenation during the resolution of this complication.