NREMT Paramedic Practice

What is an indication of shoulder dystocia during delivery?

1. The fetal head has not yet emerged

2. The fetal shoulders are wedged against the maternal symphysis pubis

3. The infant is in a breech position

4. The mother experiences severe abdominal pain

The correct answer is: The fetal shoulders are wedged against the maternal symphysis pubis

Shoulder dystocia is a delivery complication that occurs when the fetal shoulders become lodged behind the maternal symphysis pubis after the head has emerged. This condition is particularly concerning because it can lead to potential injury for both the infant and the mother if not managed promptly and effectively. The indication of shoulder dystocia is characterized by the observation that, after the fetal head has rotated and emerged, the shoulders fail to follow through the birth canal, typically becoming impacted against the maternal pelvic bone. This wedging action is what makes option B the correct indication of the condition. The other options do not accurately represent shoulder dystocia: the fetal head not having emerged is a sign of an obstructed labor rather than dystocia itself. A breech position refers to the baby being positioned to deliver buttocks or feet first, which is a separate issue from shoulder dystocia. Severe abdominal pain may be experienced by mothers during labor due to various reasons, but it is not a specific indicator of shoulder dystocia. Thus, the clear presence of wedged shoulders behind the symphysis pubis is the definitive sign of shoulder dystocia.