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Woods' manoeuvre

Extracted from Mayes Midwifery 14th Edition, Sue Macdonald & Julia Magill-Cuerden (Eds). Baillière Tindall, 2011. Courtesy Elsevier 

A manoeuvre used to assist in the delivery of the baby in shoulder dystocia.

The woman should be assisted into the lithotomy position or onto all fours to remove restrictions to the sacrum and coccyx (present when the mother is in the dorsal or semi-recumbent position). The midwife applies one hand to the mother's abdomen, putting firm but gentle pressure onto the fetal buttocks, and inserts the other into the vagina to locate the anterior surface of the posterior shoulder (clavicle). The shoulder is then rotated through 180° in the direction of the fetal back, which causes an abduction of the fetal shoulders. This rotation may dislodge the anterior shoulder and enable the posterior shoulder to enter the pelvic brim. The shoulders may then be delivered by normal downward traction and the delivery completed.

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