27/04/2024
AJOG Expert Review in Labor: A critical evaluation of the external and internal maneuvers for resolution of shoulder dystocia - Posterior arm delivery
A, The whole hand should be inserted deep enough to grasp the posterior forearm. B, The direction of traction is outward and upward to enable rotation of the posterior shoulder (curved arrow, in this scenario, clockwise direction). C, When the posterior elbow is extended, the accoucheur first has to flex it by pressing on its antecubital fossa (blue arrow) and then grasp the forearm (as in Figure 4, A). D, A common mistake is to grasp and pull the upper arm (red arrow), especially when the forearm cannot be reached. It increases the risk of humeral fracture. https://ow.ly/QN0k50Rm093