The Zavanelli maneuver for fetal shoulder dystocia. Three cases with poor outcomes.

BACKGROUND

There are several reports on the management of severe fetal shoulder dystocia by pushing the head back into the vagina and delivering the infant by cesarean section; this procedure is called the Zavanelli maneuver.

CASES: Three cases were reviewed to determine the outcomes of the infants. The three neonates all demonstrated severe perinatal hypoxia that ultimately resulted in brain damage and/or death.

CONCLUSION

Management of shoulder dystocia using the Zavanelli maneuver carries a high risk of severe infant perinatal hypoxia and damage.