• This is a technique used by the clinician when a fetus is presenting with a shoulder dystocia during a vaginal delivery
  
• The goal is to produce rotation of the fetal shoulders so that they traverse the vagina in an oblique fashion

1. Insert fingers into the patients vagina
2. Check shoulder placement
3. Place at least two fingers (index and middle) on the anterior aspect of the fetal posterior shoulder
4. Apply pressure to abduct/extend the posterior shoulder and rotate the fetal body 180°
   
1. After 90° the practitioner may need to switch hands in order to complete the full 180° turn
5. This movement rotates the anterior shoulder from under the symphysis pubis and releases the impaction (shoulder dystocia)

Variations:

1. Reverse corkscrew maneuver (use if initial rotational efforts fail)
1. Place fingers on the back of the posterior shoulder of the fetus and rotate in the opposite direction

• The combination of the Woods Corkscrew maneuver and the Rubin II maneuver may be more successful than either maneuver performed alone
• May require episiotomy to provide room for posterior manipulation

Editor:

• Anthony J. Busti, MD, PharmD, FNLA, FAHA

Last Updated:  September 2016

1. Benrubi, Guy. Handbook of Obstetric and Gynecologic Emergencies. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2012; 168.
2. Ratcliffe, Stephen D. Family Medicine Obstetrics. 3rd ed. Philadelphia, PA: Elsevier Health Sciences, 2008; 468