Symphyseal separation, sacroiliac joint dislocation and transient lateral femoral cutaneous neuropathy associated with McRoberts' maneuver - A case report

BACKGROUND: McRoberts' maneuver is often used prophylactically with the ons et of active maternal expulsive efforts or immediately before delivery of t he fetus. CASE: A 31-year-old woman, gravida 1, para 0, at 39 + 2 weeks' gestational age, was continuously maintained in an exaggerated lithotomy position while actively pushing during the second stage of labor. Immediately following s pontaneous vaginal delivery of a 3,598-g infant, the patient noted left glu teal pain and left anterior thigh dysesthesia. Orthopedic evaluation reveal ed a 5-cm symphyseal separation, sacroiliac joint dislocation and transient lateral femoral cutaneous neuropathy. The patient underwent closed reducti on of the left hemipelvis,followed by open reduction and internal fixation of the symphysis pubis two weeks later after failing conservative treatment . CONCLUSION: Although McRoberts' maneuver is generally safe, care should be exercised with use of excessive force or prolonged placement of the patient 's legs in a hyperflexed position.