The Rubin technique involves which of the following maneuvers?

The Rubin technique involves which of the following maneuvers?

• A. Fetal shoulders adducted and displaced into an oblique position to allow the posterior arm into the pelvis
• B. Rotating the fetal head to a transverse lie
• C. Applying pressure to the posterior shoulder to facilitate external rotation
• D. Hyperflexing the maternal hips to widen the pelvic outlet

Answer: (A)

The Rubin maneuver is an internal rotation technique used for shoulder dystocia. It involves reaching inside the vagina to contact the posterior shoulder and adducting it, then displacing the shoulder into an oblique position so the posterior arm can drop into the pelvis. This rotation helps align the fetus with the pelvic outlet and reduces the bisacromial width, allowing delivery of the posterior shoulder and arm, and ultimately freeing the anterior shoulder. This approach differs from maneuvers that simply rotate the head or apply external force on the shoulders. For example, hyperflexing the mother’s hips (McRoberts) is a separate initial maneuver, and rotating the head or applying external pressure to the shoulders corresponds to other techniques. The key idea of this option is the internal rotation accomplished by adducting and repositioning the shoulders to bring the posterior arm into the pelvis.

The Rubin maneuver is an internal rotation technique used for shoulder dystocia. It involves reaching inside the vagina to contact the posterior shoulder and adducting it, then displacing the shoulder into an oblique position so the posterior arm can drop into the pelvis. This rotation helps align the fetus with the pelvic outlet and reduces the bisacromial width, allowing delivery of the posterior shoulder and arm, and ultimately freeing the anterior shoulder.

This approach differs from maneuvers that simply rotate the head or apply external force on the shoulders. For example, hyperflexing the mother’s hips (McRoberts) is a separate initial maneuver, and rotating the head or applying external pressure to the shoulders corresponds to other techniques. The key idea of this option is the internal rotation accomplished by adducting and repositioning the shoulders to bring the posterior arm into the pelvis.