During a vaginal birth, what does the "turtle sign" indicate?

The "turtle sign" is a clinical indication that suggests the possibility of shoulder dystocia during a vaginal delivery. This sign is characterized by the baby's head emerging during delivery and then retracting back towards the maternal perineum after the initial emergence. This retraction occurs because the anterior shoulder becomes entrapped behind the mother's pubic symphysis, which is a key feature of shoulder dystocia.

Recognizing the turtle sign is crucial for healthcare providers, as it serves as a warning to anticipate complications and take appropriate measures to manage the situation effectively. It highlights the need for immediate intervention to avoid injury to both the baby and the mother. Understanding this sign allows practitioners to prepare for more advanced maneuvers if needed to resolve the dystocia and facilitate a safe delivery.