Zavanelli's manoeuvre

Obstetrical manoeuvre sometimes used when the baby's head is born but the shoulders are stuck. The head is pushed gently back into the vagina and the baby is delivered immediately by Caesarean section.

The concept of cephalic replacement (Gunn Zavanelli-O'Leary manoeuvre) was developed for the treatment of undeliverable bilateral shoulder dystocia by David Gunn in 1976, when he was a senior obstetrics and gynecology resident at Vanderbilt.

The manoeuvre was named for Zavanelli by a professor at Stanford University who heard about it from Zavanelli, who was volunteer-teaching in the OBGYN wards at the time. The Stanford professor included the manoeuvre in a book that he subsequently published.

• Eugene C. Sandberg:
  The Zavanelli maneuver: a potentially revolutionary method for the resolution of shoulder dystocia.
  American Journal of Obstetrics and Gynecology, St. Louis, 1985, 52:479.
• J. O'Leary:
  Shoulder dystocia. Contemporary Obstetrics and Gynecology, 1986, 27: 78.
• J. O'Leary and D. Gunn:
  Cephalic replacement for shoulder dystocia.
  Contemporary Obstetrics and Gynecology, 1986, 27: 157.
• Eugene C. Sandberg:
  The Zavanelli maneuver extended: progression of a revolutionary concept.
  American Journal of Obstetrics and Gynecology, St. Louis, 1988, 158: 1347.
• J. O'Leary and N. Pollack:
  The McRobert’s maneuver for shoulder dystocia. American Journal of Obstetrics and Gynecology, Surgical Forum, St. Louis, 1989, 40: 467.
• J. O'Leary:
  Clinical opinion - shoulder dystocia: Prevention and treatment.
  American Journal of Obstetrics and Gynecology, St. Louis, 1990: 162 (1): 5.
• J. O'Leary and H. Leonetti:
  Shoulder dystocia: Prevention & treatment.
  American Journal of Obstetrics and Gynecology, St. Louis, 1990, 162: 5.
• J. O'Leary, A. Cuva:
  Abdominal rescue after failed cephalic replacement.
  Obstetrics and Gynecology, New York, 1992, 80: 514-616..
• J. O'Leary:
  Shoulder Dystocia.
  Chapter 22 of Operative Obstetrics, 2nd edition, McGraw-Hill, N.Y. 1992.
• J. O'Leary:
  Cephalic replacement for shoulder dystocia: Present status and role.
  Obstetrics and Gynecology, New York, 1993, 82: 847-850.
• Eugene C. Sandberg:
  The Zavanelli Maneuver: 12 years of recorded experience.
  Obstetrics and Gynecology, New York, 1999, 93: 312-317.
• Kay Torney Souter:
  Reconfiguring the Hysterical Body: Midwifery narratives meet the Zavanelli Manoeuvre.
  In: Literature and Medicine, Johns Hopkins University Press, May 1994, pp 158-178.
• Fa Saad and H. A. Sharara:
  Locked Twins: A Successful outcome after applying the Zavanelli Manoeuvre.
  Journal of Obstetrics & Gynaecology, 1997, 17(4): 366-367.
• J. H. Vollebergh and P. W. van Dongen:
  The Zavanelli manoeuvre in shoulder dystocia: case report and review of published cases.
  European Journal of Obstetrics, Gynecology, and Reproductive Biology, Amsterdam, 2000, 89 (1): 81-84.