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Expert offers tips on tackling shoulder dystocia. (All-Fours Maneuver may be Advantageous).
LAKE TAHOE, NEV. -- Because there's no sure away of predicting shoulder dystocia, physicians would do better to shift their focus from trying to avoid it to learning the best strategies to deal with it, Dr. Thomas Benedetti said at an obstetrics and gynecology conference sponsored by the University of California, Davis.
Physicians probably have more time than they think to work on getting the baby out safely. "We used to think that after 2-3 minutes from the time of the shoulder dystocia you were getting into trouble if the baby wasn't delivered. But now there's some suggestion that up to 5 minutes may not increase the risk of injury, and some data even suggest that the critical time may stretch to 7 or 8 minutes if the fetal heart rate is normal," said Dr. Benedetti, professor and director of perinatal medicine at the University of Washington, Seattle.
Physicians should start a stopwatch or get a colleague to time then when they start tackling the dystocia, because "it's hard to keep track of the time, and often when we are under that kind of stress we mistakenly think much more time has passed than is actually the case," he said.
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