Effectiveness of McRoberts and Rubin Maneuvers in the Management of Shoulder Dystocia: A Systematic Review

Abstract

Shoulder dystocia is an obstetric emergency that occurs when the baby’s shoulder becomes stuck behind the mother’s pubic bone after the head has been delivered. It occurs in about 0.2–3% of vaginal births and can cause serious complications for both the mother and baby. Because it is difficult to predict, quick and effective management is very important. The two most common techniques used to manage shoulder dystocia are the McRoberts maneuver and the Rubin maneuver. The McRoberts maneuver involves flexing the mother’s legs toward her abdomen to widen the pelvic outlet and help release the baby’s shoulder. The Rubin maneuver involves applying pressure above the pubic bone or rotating the baby’s shoulder to reduce the obstruction and assist delivery. The McRoberts maneuver is usually the first method used because it is simple, fast, and effective. It is often combined with the Rubin maneuver to improve the chance of successful delivery. If these methods do not work, other obstetric maneuvers may be needed. Studies have explored whether using the McRoberts maneuver before shoulder dystocia occurs can prevent the condition. However, current evidence is still limited, and more research is needed to confirm its effectiveness. Overall, the McRoberts and Rubin maneuvers are important techniques for managing shoulder dystocia. Early recognition, prompt action, and proper training of healthcare professionals are essential to reduce complications and ensure a safer delivery for both mother and baby.