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Abstract：
BACKGROUND: Shoulder dystocia is an unpredictable and potentially catastrophic complication of vertex vaginal delivery. Posterior axilla sling traction (PAST) has recently been proposed as a method to resolve severe shoulder dystocia when commonly used techniques have failed.
METHODS: A 33-year-old woman (gravida 5, para 0) at 35 weeks, 1 day gestation underwent induction of labor for poorly controlled type 2 diabetes mellitus. Delivery of the large-for-gestational-age infant (4,060 g) was complicated by intractable shoulder dystocia, relieved at 3 minutes with PAST, resulting in a deep, circumferential laceration of the fetal posterior shoulder and contralateral phrenic nerve palsy.
CONCLUSIONS: PAST provides a potentially lifesaving option during intractable shoulder dystocia. Simulation or education about the technique facilitates its use when standard maneuvers fail. It is important to disseminate information about potential complications associated with these novel maneuvers.
METHODS: A 33-year-old woman (gravida 5, para 0) at 35 weeks, 1 day gestation underwent induction of labor for poorly controlled type 2 diabetes mellitus. Delivery of the large-for-gestational-age infant (4,060 g) was complicated by intractable shoulder dystocia, relieved at 3 minutes with PAST, resulting in a deep, circumferential laceration of the fetal posterior shoulder and contralateral phrenic nerve palsy.
CONCLUSIONS: PAST provides a potentially lifesaving option during intractable shoulder dystocia. Simulation or education about the technique facilitates its use when standard maneuvers fail. It is important to disseminate information about potential complications associated with these novel maneuvers.
摘要：
背景：肩难产是顶点阴道分娩的一种不可预测的潜在灾难性并发症。最近提出了后腋下吊带牵引（PAST）作为解决常用技术失败时严重肩难产的方法。
方法：一名33岁女性（gravida5，para0）在35周时，妊娠1天对控制不佳的2型糖尿病进行引产。大胎龄婴儿（4,060g）的分娩并发顽固性肩难产，在过去的3分钟缓解，导致一个深刻的，胎儿后肩周裂伤和对侧膈神经麻痹。
结论：PAST在难治性肩难产期间提供了一种潜在的挽救生命的选择。当标准操作失败时，有关该技术的模拟或教育有助于其使用。重要的是传播有关与这些新颖动作相关的潜在并发症的信息。
方法：一名33岁女性（gravida5，para0）在35周时，妊娠1天对控制不佳的2型糖尿病进行引产。大胎龄婴儿（4,060g）的分娩并发顽固性肩难产，在过去的3分钟缓解，导致一个深刻的，胎儿后肩周裂伤和对侧膈神经麻痹。
结论：PAST在难治性肩难产期间提供了一种潜在的挽救生命的选择。当标准操作失败时，有关该技术的模拟或教育有助于其使用。重要的是传播有关与这些新颖动作相关的潜在并发症的信息。
