{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:42:39Z","timestamp":1787920959611,"version":"build-2784847793"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T00:00:00Z","timestamp":1562716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>At Counties Manukau Health in Auckland, New Zealand, axillary traction is being used when an internal manoeuvre is required for resolution of shoulder dystocia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study presents the outcomes for mother and baby from use of axillary traction and other internal manoeuvres.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Retrospective review of the clinical records of mother and baby for all labours complicated by shoulder dystocia was carried out for an eight\u2010year period. Maternal and neonatal information were compared for the three cohorts of the first internal manoeuvre documented: axillary traction, posterior arm delivery and rotational manoeuvres.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 226 women who required the use of internal manoeuvres with no significant differences in age, body mass index, parity, ethnicity, diabetes incidence, induction and augmentation of labour rates, length of the first stage and birth weight between the cohorts. Axillary traction was the first internal manoeuvre used for 119 (52.7%) with a success rate of 95.8%. Posterior arm delivery was used first for 49 (21.7%) women with a success rate of 85.7%. Rotational manoeuvres were used first for 58 (25.7%) women with a statistically inferior success rate of 48.3%. There was no significant difference in the maternal and neonatal complication rates between the cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Axillary traction has been utilised as the first internal manoeuvre for a large number of women with a higher success rate than other internal manoeuvres without any increase in maternal or neonatal morbidity. It is recommended that this be the first internal manoeuvre attempted when shoulder dystocia occurs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13029","type":"journal-article","created":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T02:25:37Z","timestamp":1562811937000},"page":"627-633","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Axillary traction: An effective method of resolving shoulder dystocia"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9826-2943","authenticated-orcid":false,"given":"Lesley","family":"Ansell","sequence":"first","affiliation":[{"name":"Birthing and Assessment Middlemore Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Alan","family":"Ansell","sequence":"additional","affiliation":[{"name":"Women's Health Middlemore Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"McAra\u2010Couper","sequence":"additional","affiliation":[{"name":"Faculty of Health and Environmental Sciences Auckland University of Technology Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter John","family":"Larmer","sequence":"additional","affiliation":[{"name":"Faculty of Health and Environmental Sciences School of Clinical Sciences Auckland University of Technology Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas Kenneth Gerald","family":"Garrett","sequence":"additional","affiliation":[{"name":"Faculty of Health and Environmental Sciences Department of Biostatistics and Epidemiology Auckland University of Technology Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2014.04.005"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-200206000-00006"},{"key":"e_1_2_6_4_1","unstructured":"Royal College of Obstetricians and Gynaecologists (RCOG).Shoulder Dystocia Guideline No. 42.London:Guidelines and Audit Committee of RCOG;2012."},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-486X.2007.00231.x"},{"key":"e_1_2_6_6_1","unstructured":"Advanced Life Support in Obstetrics (ALSO).Advanced Life Support in Obstetrics. Course Syllabus Part I.USA:American Academy of Family Physicians;2000."},{"key":"e_1_2_6_7_1","first-page":"306","article-title":"Shoulder dystocia. ACOG Practice Pattern No. 7","volume":"60","author":"American College of Obstetrics and Gynecology (ACOG)","year":"1998","journal-title":"Int J Gynecol Obstet"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005721-199911000-00009"},{"key":"e_1_2_6_9_1","first-page":"461","article-title":"Shoulder dystocia: a qualitative exploration of what works","volume":"28","author":"Ansell Irving L","year":"2012","journal-title":"Midwifery"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2016.1264070"},{"key":"e_1_2_6_11_1","first-page":"755","article-title":"Impacted shoulders \u2013 a personal experience","volume":"108","author":"Schramm M","year":"1983","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000287615.35425.5c"},{"key":"e_1_2_6_13_1","unstructured":"Ministry of Health (MoH).Report on Maternity 2015.Wellington:Ministry of Health;2017."},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14841"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2012.01425.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2007.02.010"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1017\/S096553950500152X"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2016.05.047"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(95)00188-W"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fajo.13029","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13029","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.13029","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T04:21:37Z","timestamp":1693196497000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13029"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,10]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1111\/ajo.13029"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13029","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,10]]},"assertion":[{"value":"2018-08-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}