McRoberts maneuver

McRoberts maneuver is a common obstetric procedure often used in the second stage of labor to assist in the delivery of a baby when shoulder dystocia occurs. This maneuver involves hyperflexing the mother's legs tightly to her abdomen. This widens the pelvis, and can help the physician to dislodge the baby's shoulder.

Procedure

The McRoberts maneuver is performed with the mother in the lithotomy position. The mother's legs are grasped at the knees and sharply flexed towards her chest. This action causes a rotation of the pelvis which can often free the impinged shoulder. The maneuver is often combined with suprapubic pressure, where an assistant pushes down just above the mother's pubic bone, attempting to move the baby's shoulder towards its chest.

Effectiveness

The McRoberts maneuver is considered to be one of the most effective first-line interventions for shoulder dystocia. It is successful in resolving the dystocia in up to 42% of cases. The maneuver is simple to perform, does not require special equipment, and can be performed quickly. It is also considered to be safe for both the mother and the baby.

Risks and Complications

While the McRoberts maneuver is generally considered safe, it is not without risks. Potential complications can include maternal discomfort, bruising, and rarely, fracture of the mother's femur. For the baby, potential complications can include brachial plexus injury, hypoxia, and rarely, fracture of the clavicle or humerus.

History

The McRoberts maneuver was first described in the medical literature in 1983 by Dr. George McRoberts. It has since become a standard part of the obstetrician's toolkit for managing shoulder dystocia.

See Also

• Shoulder dystocia
• Obstetric maneuvers
• Brachial plexus injury

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