Abdominal Circumference >95th Percentile in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#17510

SMLE Question #17510

Obstetrics & Gynecology General Gynecology

Objective: OBJ-ETH-STERIL

Last updated: February 2026
A 31-year-old G2P1 woman at 39+2 weeks’ gestation is in active labor. Pregnancy is complicated by pregestational type 2 diabetes mellitus and obesity (BMI 36 kg/m²). Ultrasound at 38 weeks estimated fetal weight 4.2 kg with abdominal circumference >95th percentile. During vaginal delivery, the fetal head delivers then retracts against the perineum, and the shoulders do not deliver with gentle traction. McRoberts positioning has been attempted without success. Which of the following is the most appropriate next maneuver to relieve the dystocia?

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