This delivery complication is most commonly associated with macrosomic infants.

• A. Shoulder dystocia
• B. Abruption
• C. Precipitous birth
• D. Prolapsed cord

Answer: (A)

Macrosomia increases the risk of shoulder dystocia during delivery; when a very large infant’s head is born, the shoulders may be too wide to pass through the birth canal and become impacted behind the pubic symphysis. This delays full delivery and can compromise fetal oxygenation if not recognized and managed promptly. The typical response focuses on rapid, specific maneuvers to free the shoulder, such as creating more room in the pelvis with hip flexion (McRoberts maneuver) and applying upward pressure on the anterior shoulder (suprapubic pressure), sometimes followed by delivering the posterior arm to reduce the shoulder diameter and enable rotation. If these measures fail, additional techniques or a cesarean may be needed.

Other options are not characteristically linked to larger babies: placental abruption involves placental separation and bleeding rather than a fetal size issue; a precipitous birth is an unusually rapid delivery; and prolapsed cord involves the cord slipping ahead of the presenting part, often with a high presenting part or malpresentation, not specifically associated with macrosomia.