A vállelakadás a szülészet egyik legriasztóbb, legaggasztóbb, legváratlanabb vészhelyzete. Olyan helyzet, amikor a magzat megszületése a fej megszületését követő fájás alatt sem következik be, és további műfogások szükségesek a magzat világrahozatalához. Sok tényezőt lehet a vállelakadással kapcsolatba hozni, de a legtöbb esetben előjel nélkül, kiszámíthatatlanul következik be. Gyakorisága 0,2–0,6%. Tekintettel arra, hogy a fej megszületése után a köldökzsinór beszorul a medence üregébe, a kórkép magzati hypoxiát okoz. Ezért vállelakadás esetén a vészhelyzet azonnali, higgadt és hatékony kezeléséhez a helyzet felismerése és a megfelelő műfogások korrekt alkalmazása szükségesek. A McRoberts-manőver, a szeméremcsont feletti nyomás, belső forgatás és a hátsó kar kifejtése növelik a magzat spontán megszületésének esélyét. Végső esetben, életmentés céljából a Zavanelli-műfogás, a cleidotomia és a symphysiotomia áll rendelkezésre. A vállelakadás megoldására nincs ideális kezelés, nincs precíz, minden helyzetben hatékony manipulációs tevékenységsorozat. A szövődmény szakszerű ellátása során is súlyos anyai és magzati szövődmények jöhetnek létre, amelyek akár a magzat halálához is vezethetnek. Orv. Hetil., 2012, 153, 763–767.
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