Shoulder dystocia Quiz: Ace Your Exams
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A 30-year-old woman, gravida 2 para 2 at 41 weeks' gestation, is undergoing induction of labor for pre-labor rupture of membranes (PROM). She experienced rupture of membranes 24 hours ago, and spontaneous labor did not occur with expectant management. She has received regular prenatal care, and this pregnancy has been uncomplicated. Her previous pregnancy was also uncomplicated and resulted in a vaginal delivery of an infant at term whose weight was within normal limits. Past medical and surgical histories are unremarkable. Vital signs are within normal limits. She is 10 cm dilated and 100% effaced. The presentation is cephalic at station 0 cm. After 20 minutes of pushing, the head delivers. The shoulders do not deliver with gentle downward traction. Which of the following clinical signs is indicative of the likely diagnosis?
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