Abstract：
BACKGROUND: Shoulder dystocia is an unpredictable obstetric condition with potential long-term neonatal complications. The risk of neonatal injury might be related to the condition itself as well as to the obstetrics maneuvers used for its release.
OBJECTIVE: To examine the available evidence to assess current management and possible improvement of outcomes.
METHODS: A comprehensive search of MEDLINE, EMBASE, EMCARE, and The Cochrane Library database was performed, all studies reporting on neonatal outcomes in cases of shoulder dystocia stratified by obstetric maneuvers used for delivery were included. Data abstraction was performed and checked by two independent reviewers.
RESULTS: McRoberts maneuver was the least associated with risk of neonatal injury (odds ratio 0.6, 95% confidence interval 0.4-0.9), followed by delivery of posterior arm.
CONCLUSIONS: Delivery of posterior arm might be prioritized in cases of shoulder dystocia after failed McRoberts. Neonatal hypoxic injury correlates with the duration of dystocia rather than the maneuver used.
OBJECTIVE: To examine the available evidence to assess current management and possible improvement of outcomes.
METHODS: A comprehensive search of MEDLINE, EMBASE, EMCARE, and The Cochrane Library database was performed, all studies reporting on neonatal outcomes in cases of shoulder dystocia stratified by obstetric maneuvers used for delivery were included. Data abstraction was performed and checked by two independent reviewers.
RESULTS: McRoberts maneuver was the least associated with risk of neonatal injury (odds ratio 0.6, 95% confidence interval 0.4-0.9), followed by delivery of posterior arm.
CONCLUSIONS: Delivery of posterior arm might be prioritized in cases of shoulder dystocia after failed McRoberts. Neonatal hypoxic injury correlates with the duration of dystocia rather than the maneuver used.
摘要：
背景：肩难产是一种不可预测的产科疾病，具有潜在的长期新生儿并发症。新生儿受伤的风险可能与病情本身以及用于其释放的产科操作有关。
目的：检查现有证据以评估当前的管理和可能的结局改善。
方法：全面搜索MEDLINE，EMBASE,EMCARE,进行了Cochrane图书馆数据库，纳入了所有报告新生儿结局的研究,这些研究通过产科手术进行分层的肩难产进行分娩.数据抽象由两个独立的审阅者执行和检查。
结果：McRoberts动作与新生儿受伤的风险最小（比值比0.6，95％置信区间0.4-0.9），然后是后臂的分娩。
结论：在McRoberts失败后肩难产的情况下，可以优先考虑后臂分娩。新生儿缺氧损伤与难产的持续时间相关，而不是使用的策略。
目的：检查现有证据以评估当前的管理和可能的结局改善。
方法：全面搜索MEDLINE，EMBASE,EMCARE,进行了Cochrane图书馆数据库，纳入了所有报告新生儿结局的研究,这些研究通过产科手术进行分层的肩难产进行分娩.数据抽象由两个独立的审阅者执行和检查。
结果：McRoberts动作与新生儿受伤的风险最小（比值比0.6，95％置信区间0.4-0.9），然后是后臂的分娩。
结论：在McRoberts失败后肩难产的情况下，可以优先考虑后臂分娩。新生儿缺氧损伤与难产的持续时间相关，而不是使用的策略。
