Woods Screw Maneuver During Labor and Delivery
What Is the Woods Screw Maneuver?
The Woods screw maneuver (also called Woods corkscrew) is a technique used by doctors to free a baby from the birth canal in cases of shoulder dystocia.
Shoulder dystocia is a frightening medical emergency during birth in which the baby’s head is delivered, but the shoulders remain lodged against the mother’s pubic bone. When this happens, the Woods screw maneuver may be used to release the child's impacted shoulder. The doctor’s hand is placed behind the non-impacted shoulder of the baby. The shoulder is rotated in a corkscrew maneuver until the impacted shoulder is released.
How Frequently Does Shoulder Dystocia Occur?
As reported by American Family Physician, incidence of shoulder dystocia varies, depending on the size of the unborn baby. It occurs at a rate of 0.6% to 1.4% with infants weighing from 5 lbs. 8 oz. to 8 lbs. 13 oz. The rate increases to 5% to 9% among infants weighing 8 lbs. 13 oz. to 9 lbs. 14 oz. born to mothers who do not have diabetes.
Shoulder dystocia occurs with equal frequency among women delivering their first child and those who have giving birth to children in the past. This complication is more common among women who have diabetes.
Risk Factors for Shoulder Dystocia
The primary risk factor for shoulder dystocia is the use of forceps and vacuum extractors during delivery. Other risk factors include:
- Post term pregnancy, beyond 42 weeks
- Gestational diabetes
- Abnormal maternal pelvic anatomy
- Previous birth with shoulder dystocia occurrence
- Short maternal stature
- Infant weighing more than 8 lbs. 13 oz.
- Protracted active phase in first stage labor
- Protracted second stage labor
Emergency Medical Response to Shoulder Dystocia
When risk factors are present, medical professionals should be fully prepared to act quickly and effectively should shoulder dystocia occur. This condition is immediately apparent when the head of the fetus emerges and then retracts against the perineum, which is known as the "turtle sign."
The exact steps to be taken should be determined in advance, and corrective actions, such as the Woods screw maneuver, must be properly performed - without excessive force. Otherwise, this maneuver could cause serious injury to both mother and the baby.
Complications of Shoulder Dystocia
When shoulder dystocia occurs during delivery, severe complications can occur, particularly when health care providers do not quickly respond with the correct procedures, properly administered, to attempt to resolve this critical medical emergency.
Maternal Complications with Shoulder Dystocia
Potential damage to the mother may include:
- Uterine rupture
- Third- or fourth-degree episiotomy or tear
- Rectovaginal fistula (abnormal passage between the rectum and the vagina)
- Postpartum hemorrhage
Fetal Complications with Shoulder Dystocia
Infants may suffer serious birth injuries when shoulder dystocia occurs, including:
- Brachial plexus palsy (weakness or paralysis from damage to the nerves travelling from the spinal cord at the neck to the shoulder, arm, and hand)
- Fracture of the clavicle (collar bone)
- Fracture of the humerus (upper arm bone)
- Hypoxia (oxygen deprivation), with or without permanent neurological damage
Contact a Birth Injury Lawyer
If you or your newborn suffered serious injuries during labor or delivery, please contact the birth injury attorneys at Birth Injury Safety at (214) 974-4121 to get help. We can answer your questions concerning the possibility of medical malpractice. To help determine how you can take legal action if medical negligence led to serious injury or loss of life, please call today for a free consultation.
- American Family Physician: Shoulder Dystocia