Which obstetric emergency occurs when the fetal head delivers but the shoulders arrest their passage?

• A. Uterine rupture
• B. Shoulder dystocia
• C. Breech delivery
• D. Placental abruption

Answer: (B)

Shoulder dystocia is the situation described when the head has just delivered but the shoulders become stuck and cannot pass through the birth canal. This occurs because the anterior shoulder is wedged behind the pubic symphysis, delaying the rest of the body’s delivery. It’s an emergency because prolonged shoulder impaction can compromise the baby’s oxygen supply and lead to injury, while the mother can also be at risk for injury if delivery is delayed.

This scenario is not uterine rupture, breech delivery, or placental abruption. Uterine rupture typically presents with sudden, severe abdominal pain, loss of fetal well-being, and abnormal contractions. Breech delivery involves the baby delivering buttocks or feet first, not the head followed by stuck shoulders. Placental abruption usually presents with painful vaginal bleeding and a tender, rigid uterus, not the specific sequence of head delivery followed by shoulder arrest.

Management focuses on rapid recognition and immediate, appropriate maneuvers to release the impaction (such as McRoberts positioning and suprapubic pressure) and, if needed, additional internal maneuvers, while preparing for swift transport to a delivery-capable facility.