Distosia de Hombro

Ask for help: ask patient to push hard, ask nursing to drop head of bed down, and call for anesthesia and the pediatrician.
Legs: hyperflex legs (McRobert's manoeuvre) to open pelvis in AP direction (helpful in up to 40% of shoulder dystocias).
A: Disimpact the Anterior shoulder with suprapubic pressure (not fundal presure). Can also try to rotate shoulders to oblique plane by inserting two fingers posteriorly into the vagina and pushing on the front posterior shoulder to move it off the midline
Release posterior arm: find fetal forearm and hand and sweep it across the chest
Maneuver of Woods - Corkscrew maneuver
Episiotomy: not helpful to free infant, but can create more room
R: roll mother onto all fours to free impacted shoulder.