{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:10:18Z","timestamp":1777378218535,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,11,24]],"date-time":"2015-11-24T00:00:00Z","timestamp":1448323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Royal Dutch College of Midwives"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In the Netherlands, low\u2010risk pregnancies are managed by midwives in primary care. Despite strict definitions of low risk, obstetric complications can occur. Midwives seldom encounter uncommon labour complications, but are sufficiently trained to manage these. We assessed neonatal and maternal outcome after management of shoulder dystocia in primary midwifery care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>In this 2\u2010year prospective cohort study from April 2008 to April 2010, primary\u2010care midwives, who participated in an obstetric emergency course, reported all obstetric complications. Main outcome was neonatal and maternal outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In sixty\u2010four cases of shoulder dystocia McRoberts was the first maneuver in 42\/64 (65.6%) cases with a success rate of 23.8%. All\u2010fours maneuver was most frequently used as the second maneuver (24\/45; 53.3%). No neonatal mortality occurred, none of the infants suffered from hypoxic ischemic injury, two (3.1%) had transient brachial plexus injuries, two (3.1%) had fractured clavicles and one (1.6%) had a fractured humerus. Eight (12.5%) neonates were successfully resuscitated because of birth asphyxia. All infants fully recovered. In neonates with immediate adverse outcome significantly more maneuvers were used compared with those without adverse neonatal outcome (<jats:italic>p<\/jats:italic> = 0.02). Postpartum hemorrhage occurred in 2\/64 (3.1%) women, deep vaginal lacerations in 2\/64 (3.1%), perineal tears in 23\/64 (35.9%). No anal sphincter injuries occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>McRoberts and all\u2010fours maneuvers are widely used by primary\u2010care midwives in the management of shoulder dystocia. Low rates of adverse neonatal and maternal outcomes were observed in cases of shoulder dystocia up to 6 weeks postpartum.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12800","type":"journal-article","created":{"date-parts":[[2015,10,13]],"date-time":"2015-10-13T20:03:15Z","timestamp":1444766595000},"page":"203-209","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Shoulder dystocia in primary midwifery care in the Netherlands"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6078-1185","authenticated-orcid":false,"given":"Athanasios F.","family":"Kallianidis","sequence":"first","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7258-9641","authenticated-orcid":false,"given":"Marrit","family":"Smit","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6746-3259","authenticated-orcid":false,"given":"Jos","family":"Van Roosmalen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Centre Leiden the Netherlands"},{"name":"Athena Institute VU University Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,11,24]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Managing obstetric emergencies and trauma \u2013 the MOET course manual","author":"Grady K","year":"2007"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2014.04.002"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2014.04.003"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01354.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.12.038"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)00542-5"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(98)70382-5"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2004.06.010"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2014.04.005"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.09.007"},{"key":"e_1_2_10_12_1","first-page":"439","article-title":"All\u2010fours maneuver for reducing shoulder dystocia during labor","volume":"43","author":"Bruner JP","year":"1998","journal-title":"J Reprod Med"},{"key":"e_1_2_10_13_1","first-page":"625","article-title":"A new (old) maneuver for the management of shoulder dystocia","volume":"32","author":"Meenan AL","year":"1991","journal-title":"J Fam Pract"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2006.06.002"},{"key":"e_1_2_10_15_1","volume-title":"Shoulder dystocia green\u2010top guideline No.4","author":"Royal College of Obstetricians and Gynaecologists","year":"2012"},{"key":"e_1_2_10_16_1","volume-title":"[Dutch Society of Obstetrics and Gynaecology]. 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