American Journal of Obstetrics & Gynecology
Volume 191, Issue 3 , Pages 874-878 , September 2004

Randomized trial of McRoberts versus lithotomy positioning to decrease the force that is applied to the fetus during delivery

  • Sarah H. Poggi, MD

      Affiliations

    • Georgetown University Hospital, Department of Obstetrics and Gynecology, Washington, DC
    • Corresponding Author InformationReprint requests: Sarah H. Poggi, MD, Department of Obstetrics and Gynecology, 3800 Reservoir Road-3PHC, Washington, DC 20007.
    • ,
  • Robert H. Allen, PhD

      Affiliations

    • Johns Hopkins University, Department of Biomedical Engineering, Baltimore, Md
    • ,
  • Chirag R. Patel, BS

      Affiliations

    • Johns Hopkins University, Department of Biomedical Engineering, Baltimore, Md
    • ,
  • Alessandro Ghidini, MD

      Affiliations

    • Georgetown University Hospital, Department of Obstetrics and Gynecology, Washington, DC
    • ,
  • John C. Pezzullo, PhD

      Affiliations

    • Georgetown University Hospital, Department of Obstetrics and Gynecology, Washington, DC
    • ,
  • Catherine Y. Spong, MD

      Affiliations

    • Georgetown University Hospital, Department of Obstetrics and Gynecology, Washington, DC

References 

  1. Acker DB, Sachs BP, Friedman EA. Risk factors for shoulder dystocia. Obstet Gynecol. 1985;66:762–768
  2. Spong CY, Beall M, Rodrigues D, Ross MG. An objective definition of shoulder dystocia: prolonged head to body delivery intervals and/or the use of ancillary obstetric maneuvers. Obstet Gynecol. 1995;86:433–440
  3. McFarland MB, Langer O, Piper JM, Berkus MD. Perinatal outcome and the type and number of maneuvers in shoulder dystocia. Int J Gynecol Obstet. 1996;55:219–224
  4. Gherman RB, Ouzounian JG, Goodwin TM. Obstetric maneuvers for shoulder dystocia and associated fetal morbidity. Am J Obstet Gynecol. 1998;178:1126–1130
  5. Gonik B, Stringer C, Held B. An alternate maneuver for management of shoulder dystocia. Am J Obstet Gynecol 1983;145:882-4.
  6. American College of Obstetrics and Gynecology . Shoulder dystocia. Washington (DC): The College; 2002;ACOG Practice Bulletin no.: 5
  7. Sorab J, Allen RH, Gonik B. Tactile sensory monitoring of clinician-applied forces during delivery of newborns. IEEE Trans Biomed Eng. 1988;35:1090–1093
  8. Gonik B, Allen R, Sorab J. Objective evaluation of the shoulder dystocia phenomenon: effect of maternal pelvic orientation on force reduction. Obstet Gynecol. 1989;74:44–48
  9. Poggi SH, Spong CY, Allen RH. Prioritizing posterior arm delivery during severe shoulder dystocia: toward reducing brachial plexus injury risk. Obstet Gynecol. 2003;101:1068–1072
  10. Buhimschi CS, Buhimschi IA, Malinow A, Weiner CP. Use of McRoberts' position during delivery and increase in pushing efficiency. Lancet. 2001;358:470–471
  11. Rouse DJ, Owen J, Goldenberg RJ, Oliver SP. The effectiveness and cost of elective cesarean delivery for fetal macrosomia diagnosed by ultrasound. JAMA. 1996;276:1480–1486
  12. Beall MH, Spong CY, Ross MG. A randomized controlled trial of prophylactic maneuvers to reduce head-to-body delivery time in patients at risk for shoulder dystocia. Obstet Gynecol. 2003;102:31–35
  13. Beall MH, Spong C, McKay J, Ross M. Objective definition of shoulder dystocia: a prospective evaluation. Am J Obstet Gynecol. 1998;179:934–937
  14. Heath LT, Gherman RB. Symphyseal separation, sacroiliac joint dislocation and transient lateral femoral cutaneous neuropathy associated with McRobert's maneuver. J Reprod Med. 1999;44:902–904
  15. Gherman RB, Ouzounian JG, Incerpi MH, Goodwin TM. Symphyseal separation and transient femoral neuropathy associated with the McRoberts' maneuver. Am J Obstet Gynecol. 1998;178:609–610
  16. Allen R, Sorab J, Gonik B. Risk factors for shoulder dystocia: an engineering study of clinician-applied forces. Obstet Gynecol. 1991;77:352–355

 Supported in part by the Dougherty Fund, managed by Dr. John Queenan, Professor Emeritus at Georgetown University Hospital, for the development of the force measuring system and by H. Montgomery Hougen, who donated the laptop computer that was used in the system.Presented at the Twenty-Fourth Annual Meeting of the Society for Maternal Fetal Medicine, New Orleans, La, February 2-7, 2004.

PII: S0002-9378(04)00784-7

doi: 10.1016/j.ajog.2004.07.024

American Journal of Obstetrics & Gynecology
Volume 191, Issue 3 , Pages 874-878 , September 2004

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