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CC BY-NC-ND 4.0 · AJP Rep 2020; 10(02): e133-e138
DOI: 10.1055/s-0040-1708498
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Carit Maneuver: A Novel Approach for the Relief of Shoulder Dystocia—A Case Series

Alfredo F Gei
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Methodist Hospital, Houston, Texas
,
Jorge Suarez Mastache
2   The Department of Obstetrics and Gynecology, Hospital Rafael Calderón Guardia, San José, Costa Rica
,
Luis D. Pacheco
3   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas
,
Mariana Villanueva
4   Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Monterrey, Nuevo León
› Author Affiliations
Further Information

Publication History

27 April 2019

28 June 2019

Publication Date:
15 April 2020 (online)

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Abstract

Objective The main purpose of this article is to describe the technique and mechanism of action of a novel intervention for the relief of shoulder dystocia we are labeling Carit maneuver.

Methods We report a cohort study of eight cases of shoulder dystocia not relieved by the combination of McRobert's maneuver and suprapubic pressure treated with the Carit maneuver. This intervention involves the use of the fetal head and neck as the grasping point of the fetus to exert a ventral rotation of the fetal trunk, reduce the bi-acromial diameter, and deliver the posterior shoulder by passive displacement.

In all these cases, the direction of the original head restitution, direction of exerted rotation, and side and location of delivery of the first shoulder were recorded. Maternal and neonatal outcomes were reviewed and reported.

Results In all cases, the Carit rotational maneuver resulted in the delivery of the posterior shoulder in the transverse (4), oblique anterior (2), or direct anterior (2) diameters. No instances of neonatal depression or fetal acidemia were noted in this cohort.

Conclusion The Carit maneuver is an original and successful intervention in the management of shoulder dystocia unresponsive to McRobert's maneuver and suprapubic pressure.

Keywords

shoulder dystocia - shoulder girdle dystocia - rotational maneuver - Carit maneuver
 

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