zavanelli maneuver in one case of shoulder dystocia

ABSTRACT

The Zavanelli maneuver has typically been instituted when conventional maneuvers have failed to alleviate shoulder dystocia. Previously reported cues involving the Zavanelli maneuver have described cephalic replacement followed by immediate cesarean delivery. I encountered a case in January 2004, which, I delivered the head by outlet forceps and then despite the gentle traction that was first applied to deliver the shoulder and the even stronger traction the baby could not be delivered I felt that delivery will be very difficult and this baby is in danger of serious complications or death. Immediately I made flexion of the fetal head and then I push it backward to the vagina again. Then immediate cesarean section was done. Baby weighs 3800gm and he was alive. Now he is more than 2 year-old. The Zavanelli maneuver may be used to successfully to alleviate shoulder dystocia. A although traditionally Zavanelli maneuver is a method of last resort in the management of shoulder dystocia, consideration should be given to its use earlier in the treatment of obstructed vaginal delivery