A modified technique to deliver the posterior arm in severe shoulder dystocia.

BACKGROUND Posterior arm delivery resolves almost all cases of severe shoulder dystocia. However, if the posterior arm is extended or lies under the fetus's body, the usually described technique for its delivery may not be practicable. CASE A young, multiparous woman with type II diabetes had a low-midcavity vacuum delivery. Severe shoulder dystocia was encountered. The usual maneuvers, including the usual technique described for delivery of the posterior arm, were unsuccessful. A modified technique for delivery of the posterior arm was used. CONCLUSION Posterior axillary traction will deliver the posterior arm when it is not accessible by the usual technique.