Gentle Downward Traction in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#18761

SMLE Question #18761

Obstetrics & Gynecology General Gynecology

Objective: OBJ-OBG-shoulder-dystocia-01

Last updated: March 2026
A 30-year-old G2P1 woman at 40+2 weeks is in the second stage of labor. She has pregestational diabetes and obesity; estimated fetal weight is 4.4 kg. During vaginal delivery, the head delivers then retracts against the perineum, and the anterior shoulder does not deliver with gentle downward traction. Help is summoned, the mother is told to stop pushing, and her hips are hyperflexed onto her abdomen. Which maneuver should be performed next as the initial obstetric intervention?

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