title: [The Jacquemier's maneuver: An overview of midwives knowledge and practices in a third level maternity hospital].
abstract: OBJECTIVE
  Shoulder dystocia is an uncommon but serious complication occurring in 0.2 to 3% of deliveries. We carried out a study in order to assess the midwives experience, knowledge and practices on shoulder dystocia, at the maternity hospital of Saint-Denis, Reunion Island.
  
  
  METHODS
  The first part is a confidential questionnaire addressed to midwives working in the delivery unit. The second part is a retrospective desk review of shoulders dystocia which occurred from 2004 to 2014.
  
  
  RESULTS
  (1) The population was made up of 28 midwives, having between 1 to 27 years of experience. Seventy-five percent of them had been faced with shoulder dystocia, and 62% had realized Jacquemier's maneuver. However, only 25% received this maneuver training. Less than a third of them answered correctly to at least 7 from the 8 theoretical questions about the Jacquemier's maneuver. (2) We studied 34 shoulders dystocia, occurring between 36+5 to 41+2 gestational weeks, mostly with no risk factors found. Mac Roberts' maneuver is used as first-line in 88% of situations. Jacquemier's maneuver is used in 52.9% of cases (5.9% as first-line, 47% as second-line). In 26.4% of situations, the midwife is not able to reduce the dystocia. She usually carries out a combination of maneuvers. The gynecologist is asked only for 23.5% of dystocia and he usually uses Jacquemier's maneuver (70% of situations).
  
  
  CONCLUSIONS
  The Jacquemier's maneuver is rarely practiced (uncommon situation, lack of training). Simulation trainings should be put in place, because neonatal sequels can be avoided.
authors.affiliation: Maternité CHU de Saint-Denis, allée des Topazes, 97400 Saint-Denis, Réunion; Université de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France. Electronic address: aurelyyyyy@hotmail.fr.
authors.forename: A
authors.initials: A
authors.lastname: Chirol
authors.affiliation: Unité de soutien méthodologique, CHU de Saint-Denis, allée des Topazes, 97400 Saint-Denis, Réunion.
authors.forename: E
authors.initials: E
authors.lastname: Chirpaz
authors.affiliation: Maternité CHU de Saint-Denis, allée des Topazes, 97400 Saint-Denis, Réunion.
authors.forename: A
authors.initials: A
authors.lastname: Carassou-Maillan
mesh_terms: D001720:Birth Injuries / Q000517:prevention & control; D036861:Delivery, Obstetric / Q000193:education* / Q000379:methods*; D004420:Dystocia / Q000628:therapy*; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D008880:Midwifery / Q000193:education*; D011247:Pregnancy; D012307:Risk Factors; D012782:Shoulder; D011795:Surveys and Questionnaires
keywords: Dystocie des épaules; Jacquemier; Midwives; Practices; Pratiques; Sages-femmes; Shoulder dystocia