PENANGANAN DISTOSIA BAHU

Summary

This educational video provides a detailed guide on managing shoulder dystocia during childbirth, a condition where the baby’s shoulders become stuck after the head has been delivered. It explains the causes, such as the baby’s position, and outlines several interventions like episiotomy, McRoberts' maneuver, and suprapubic pressure. The speaker emphasizes a series of techniques to safely deliver the baby, including repositioning, manual manipulation, and, if necessary, clavicle fracture. The video is aimed at medical professionals, particularly in obstetrics, providing practical steps for managing this potentially dangerous situation.

Takeaways

• 😀 Shoulder dystocia occurs when the baby's head is delivered, but the shoulders are stuck and unable to pass through the birth canal.
• 😀 Causes of shoulder dystocia may include issues such as cord entanglement, but these have been ruled out in the provided case.
• 😀 Episiotomy is performed to widen the birth canal, helping the shoulder pass through during a shoulder dystocia situation.
• 😀 External rotation of the baby's head often does not occur during shoulder dystocia, which is common in such cases.
• 😀 The first step in managing shoulder dystocia is ensuring that the baby is in a head-down position and that the cervix is fully dilated.
• 😀 McRoberts maneuver is a technique where the mother's legs are flexed and pulled toward her chest to help open the pelvis and assist in shoulder delivery.
• 😀 Suprapubic pressure is applied to the mother's abdomen to help guide the baby's shoulders into the birth canal.
• 😀 The Wood's screw maneuver involves rotating the baby’s shoulders inside the birth canal to facilitate delivery.
• 😀 The Rubin maneuver uses a hand placed inside the vagina to rotate the baby and position the shoulders in the most favorable direction for delivery.
• 😀 If all maneuvers fail, a clavicular fracture may be performed to reduce the shoulder's diameter, allowing for the successful delivery of the baby.

Q & A

What is shoulder dystocia?

Shoulder dystocia is a condition during childbirth where the baby’s head is delivered, but the shoulders are unable to pass through the birth canal, causing a delay in delivery.

What are the potential causes of shoulder dystocia?

The potential causes of shoulder dystocia include factors such as the baby's size, the shape of the birth canal, or the position of the baby. The transcript mentions that other causes, like umbilical cord entanglement, have been ruled out in this scenario.

What initial steps are taken when shoulder dystocia is identified?

When shoulder dystocia is identified, the first step is to confirm the diagnosis by ensuring there are no other issues, such as cord entanglement. If confirmed, interventions such as performing an episiotomy are considered to help widen the birth canal.

What is the purpose of an episiotomy in managing shoulder dystocia?

An episiotomy is performed to widen the birth canal, allowing the stuck shoulder to pass through more easily. It is done during contractions to minimize the pain and avoid further complications.

What is the McRoberts Maneuver, and how does it help in shoulder dystocia?

The McRoberts Maneuver involves the mother bending her knees towards her chest, which opens the pelvis and may help to release the stuck shoulder. This technique can widen the pelvic outlet by 1-2 cm.

How does suprapubic pressure assist in shoulder dystocia?

Suprapubic pressure is applied by an assistant above the pubic bone to help move the baby's shoulder and facilitate delivery. This pressure helps the shoulder move through the birth canal.

What is the Wood's Screw Maneuver, and when is it used?

The Wood's Screw Maneuver is a technique where the healthcare provider rotates the baby's shoulder to the optimal position for delivery. It is used when other methods, like McRoberts or suprapubic pressure, have not been successful.

What does the posterior maneuver entail, and why is it used?

The posterior maneuver involves positioning the baby in a way that may help reduce the shoulder’s diameter, making it easier for the baby to be delivered. This method is typically used when other techniques have failed.

What is the extreme option for delivering the baby if all other maneuvers fail?

In extreme cases, if all other maneuvers fail, breaking the baby’s clavicle is considered. This reduces the diameter of the shoulder and may help facilitate delivery. However, this procedure should only be performed by trained professionals.

Why is it crucial for trained professionals to handle shoulder dystocia cases?

It is crucial for trained professionals to manage shoulder dystocia because the condition involves complex maneuvers that require skill and experience to avoid harm to both the mother and baby. Inexperienced handling can lead to serious complications.