What is the role of suprapubic pressure in managing shoulder dystocia?

Suprapubic pressure plays a crucial role in the management of shoulder dystocia by targeting the impacted shoulder of the fetus. When shoulder dystocia occurs, it is generally due to the anterior shoulder becoming lodged behind the pubic symphysis. Applying firm pressure just above the pubic bone can help to push the shoulder into a more favorable position, allowing it to rotate out from behind the symphysis and facilitating delivery. This technique can be an effective first-line intervention to resolve the obstruction caused by the shoulder dystocia.

In contrast, other options do not address the immediate need to resolve the mechanical blockage presented by shoulder dystocia. Reducing maternal anxiety, stimulating uterine contractions, or evaluating the fetal heart rate response do not have a direct impact on dislodging the impacted shoulder and would not be the primary focus in this urgent situation.