NREMT Paramedic Practice

The 'turtle sign' is associated with which delivery complication?

1. Prolapsed cord

2. Shoulder dystocia

3. Breech presentation

4. Cephalopelvic disproportion

The correct answer is: Shoulder dystocia

The 'turtle sign' is a clinical finding associated with shoulder dystocia during childbirth. It refers to the observable retraction of the fetal head after it has emerged from the vaginal canal. This indicates that the baby's shoulders are impacted behind the pubic bone, preventing the body from delivering following the head. The term 'turtle sign' is derived from the way a turtle retracts its head into its shell when threatened, as the fetal head appears to retract back toward the mother’s perineum. In the context of shoulder dystocia, recognizing the 'turtle sign' is crucial because it signals an urgent need for maneuvers to resolve the shoulder dystocia and facilitate safe delivery. Failure to address this complication promptly can lead to potential injuries to both the mother and the baby, including brachial plexus injury or even more severe outcomes. Understanding this sign is vital in emergency situations to ensure that appropriate interventions are executed quickly.