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DEFINISI
bahu
FAKTOR RISIKO
Makrosomia ( > 4000 gram)
Diabetes gestasi
Riwayat distosia bahu sebelumnya
Induksi persalinan
Partus lama
Pendek
KOMPLIKASI
BAYI
Kerusakan saraf (brachial plexus injury) : !0%
Kerusakan otak
Kematian bayi
IBU
Robekan vagina (derajat III/IV)
Fistula rektovaginal
Perdarahan
Gangguan emosional
Trauma pada simfisis pubis (diatesis) dengan atau tanpa
neuropati femur
Ruptur uteri
PENANGANAN
Kasus emergensi
Tidak bisa ditangani sendiri
episiotomy alone will not release the shoulder. Because most cases of
shoulder dystocia can be relieved with the McRoberts maneuver and
P : Suprapubic pressure
MANUVER RUBIN
Mengecilkan diameter antero posterior
RUBIN MANUEVRE
WOODS CORKSCREW
MANEUVER
fours position. Often, the shoulder will dislodge during the act
of turning, so that this movement alone may be sufficient to
Zavanelli maneuver
Cephalic replacement followed by cesarean delivery; involves rotating the fetal head into a
direct occiput anterior position, then flexing and pushing the vertex back into the birth
canal, while holding continuous upward pressure until cesarean delivery is accomplished.
Tocolysis may be a helpful adjunct to this procedure, although it has not been proved to
enhance success over cases in which it was not
Symphysiotomy
Intentional division of the fibrous cartilage of the symphysis pubis under local anesthesia
has been used more widely in developing countries than in North America. It should be
used only when all other maneuvers have failed and capability of cesarean delivery is
unavailable
PENCEGAHAN