Shoulder dystocia Quiz: Ace Your Exams
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A 33-year-old woman, gravida 3 para 2, is admitted to the hospital in labor and ready to begin pushing. Her previous pregnancies resulted in spontaneous vaginal deliveries of infants whose birth weights were normal. Her body mass index (BMI) prior to pregnancy was 24 kg/m2. Vital signs are within normal limits. Her cervix is 10 cm dilated, 100% effaced, and grossly ruptured membranes. The fetal head delivers after 130 minutes but immediately retracts against the perineum. Gentle downward traction of the head does not deliver the shoulders. Which of the following clinical features, if present, would be the strongest risk factor for the likely diagnosis?
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