This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Physiology & Histology, Subject name: Gynaecology & Obstetrics
Shoulder dystocia is managed by: 
Select and explain. 
A. Sharp flexion of hip joints towards abdomen, B. Supra pubic pressure, C. 90 degree rotation of posterior shoulder, D. Emergency c-section
B: Supra pubic pressure
Answer: B: Supra pubic pressure 
Explanation: Ans. b. Supra pubic pressureRef: Williams Obstetrics 24th Ed; Page No-541SHOULDER DYSTOCIADiagnosisThis diagnosis is made when delivery of the fetal shoulders is delayed after delivery of the head.It is more commonly associated with fetal shoulders in the anterior-posterior plane, with the anterior shoulder impacted behind the pubic symphysis.It occurs in 1% of the deliveries case and it may result in permanent neonatal neurologic damage in 2% of cases.Risk FactorsIt Includes obesity, maternal diabetes, and postdates pregnancy, which are associated with fetal macrosomia.The incidence may increases with birth weight, half of shoulder dystocias occur in fetuses <4,000 grams.ManagementSuprapubic pressureMaternal thigh flexion (McRoberts maneuver)Internal rotation of the fetal shoulders to the oblique plane (Wood s "corkscrew" maneuver)Manual delivery of the posterior arm, andZavanelli maneuver (cephalic replacement).