United Brachial Plexus Network, Inc.

Just wanting to find out if someone knows how the mcroberts maneuver is preferred???the right was that is and how much force really is applied...thanks to all and god bless

"McRobert's Maneuver: Flex the mother's legs toward her shoulders as she lays on her back, thus expanding the pelvic outlet. One study showed that this alleviated 42% of all cases of shoulder dystocia."

video
http://www.youtube.com/watch?v=eq9n1WJPhF4

We learned way back (from an expert witness) that the correct way to do McRoberts is to push the knees back with quite some force.

When a physician or midwife suspects shoulder dystocia there are several accepted maneuvers that can be performed to hopefully alleviate the shoulder dystocia without injury to the baby. The maneuvers need not necessarily be done in a particular order although most clinicians do describe a similar order. The first maneuver is to place the mother in a McRoberts position. In this position the mother is moved down on the bed and the legs are flexed back against the abdomen. In a correct McRoberts the legs should be held back by a nurse so that the knees go back as far as they can toward the chest. The McRoberts maneuver is often do incorrectly with the knees not being held far enough toward the chest. Drs. often write in the medical records that the mother was placed in McRoberts when in fact it was more of a lithotomy position which is not a full and proper McRoberts. The idea of the McRoberts is to change the angle of the pelvis with the idea that the shoulder of the baby will be able to slip under the mothers pubic bone. The McRoberts is often accompanied by suprapubic pressure. This is a nurse putting pressure on the infant over the mothers pelvic area in a effort to dislodge the shoulder. The nurse must be careful to apply pubic pressure and not pressure too high up over the fundus. Fundal pressure would be right below the mothers breast area. Suprapubic pressure is allowed as it is pushing the baby up off of the bone. Fundal pressure is wrong and will just lodge the shoulder more against the bone and make it harder to reduce the shoulder dystocia without injury.

The other maneuvers are a Woods/Reubens corkscrew maneuver and delivery of the anterior/posterior arm. If there is interest I would be pleased to describe those maneuvers also.

Ken Levine
Klevine@Klevinelaw.com
http://www.Klevinelaw.com
617-566-2700