NREMT Paramedic Practice

Which condition is characterized by a failure of the fetal shoulders to advance during labor?

1. Breech presentation

2. Shoulder dystocia

3. Prolapsed cord

4. Cephalopelvic disproportion

The correct answer is: Shoulder dystocia

Shoulder dystocia is characterized by a situation during labor where the fetal shoulders become lodged against the maternal pelvic bones after the head has emerged, preventing further progression of the fetus through the birth canal. In cases of shoulder dystocia, the delivery is complicated because the broader shoulders fail to advance past the symphysis pubis, which can lead to serious complications for both the mother and the infant. Understanding this condition is crucial for obstetric care, as it requires specific maneuvers and immediate intervention to resolve. Shoulder dystocia is often unforeseen and can occur even when the labor appears normal, making it vital for healthcare providers to be prepared to manage it effectively when it arises. The other conditions listed don't fit this specific scenario. For example, breech presentation refers to the position of the fetus where the buttocks or feet are positioned to deliver first, while prolapsed cord involves the umbilical cord slipping ahead of the presenting part, leading to potential cord compression. Cephalopelvic disproportion describes a mismatch between the size of the fetus and the pelvic dimensions, affecting labor progress but not specifically relating to the shoulders' position after the head has been delivered.