EXHIBIT ID: OB_A_1098

Labor and Delivery with Anterior Shoulder Dystocia

This animation displays the sagittal view of a labor and delivery with fetal anterior shoulder dystocia. Maternal anatomy highlighted in this animation includes the abdominal fat, uterus, pubic symphysis, bladder, vagina, and rectum. The fetal right anterior shoulder becomes impacted on the pubic symphysis as maternal forces propel the baby down the birth canal. The mother is placed in McRoberts position and further contractions cause stretching of the fetus' brachial plexus nerves. Shoulder dystocia was recognized and maternal forces were stopped. The physician then delivers the baby using a rotational maneuver. The newborn presents with a left humerus fracture, right phrenic nerve scarring, right C6-C8 and T1 root avulsions, right adrenal hematoma, and Horner's syndrome immediately after delivery.