Vaginal Delivery of an Extremely Macrosomic Baby with Shoulder Dystocia: A Case Report

Abstract

Background: Fetal macrosomia is a condition where a baby is born weighing more than 4000g. The prevalence of this condition in India is estimated to be around 3% of births. Macrosomia can lead to various complications in mother and the baby. Case: A multigravida woman with no known previous comorbidities like Diabetis, obesity, history of a previous macrosomic baby, post term pregnancy etc, admitted in labour at term, she progressed normally to full dilatation and delivered a macrosomic male baby of 5.925kg. We encountered shoulder dystocia during the delivery. Traditional McRoberts manoeuvre failed to deliver the shoulders and was managed by delivery of the posterior arm. Conclusion: To deliver the posterior arm, the obstetrician slides a hand along the posterior fetal shoulder and arm, grasps the forearm or wrist, and sweeps the arm across the fetal chest to deliver the posterior arm. All clinicians should have the expertise of dealing with shoulder dystocia as it can happen unexpectedly. We should be well versed with the drills and manoeuvres and should be updated with the necessary skills and knowledge when shoulder dystocia is encountered during a delivery.