Which maneuver is most effective for treatment of shoulder dystocia?
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No RCTs have evaluated which maneuver is most effective or safest for resolving a shoulder dystocia. Both the American College of Obstetricians and Gynecologists (ACOG) and the Royal College of Obstetricians and Gynaecologists (RCOG) state that McRoberts maneuver followed by (or in conjunction with) suprapubic pressure are the first interventions that should be used. A 2011 study found delivery of the posterior shoulder to be the next most effective method. If additional maneuvers are needed, they should be chosen based on provider experience and maternal factors.
Evidence Based Practice 16(5): 13.