Müse Parameter Descriptions308Late Deceleration Amplification FactorFetal heart rate (FHR) late decelerations associated with uterine contractions (UCs) are attributed toreductions in oxygen supply from the mother. The Late Deceleration Amplification Factor parameterallows for greater control over the amplitude of late decelerations in conditions where they would beexpected, notably for the fetal patient with placental insufficiency. In addition, use of this parameterallows the instructor to demonstrate late decelerations for the normal fetus in the cases of maternalhypotension and uterine hyperactivity.The Late Deceleration Amplification Factor is a multiplicative factor applied to the oxygen distributionin the fetus. Values above 1.0 speed up the propagation of reduced oxygen levels from the placenta tothe fetal arteries.Default: 1.0Range: 1.0 – 5.0Shoulder DystociaThe Shoulder Dystocia parameter needs to be set to Enabled to activate the condition of ShoulderDystocia. When Enabled, fetal descent will be interrupted when the fetal head has been delivered andrestituted. “Now in shoulder dystocia condition” will be logged in the event log, and the numeric stationindicator in the Graphic widget will display >|.When Shoulder Dystocia is Enabled, a specific maneuver can be selected that will resolve theshoulder dystocia.Default: DisabledShoulder Dystocia ResolutionThe Shoulder Dystocia Resolution parameter determines what maneuver, if any, will resolve shoulderdystocia. Six options are available: None, McRoberts, Suprapubic Pressure, Rotation of PosteriorShoulder, Rotation of Anterior Shoulder, and Zavanelli. By default, shoulder dystocia resolution is set toNone.The McRoberts option activates the automatic resolution of shoulder dystocia upon the detection ofthe McRoberts maneuver performed correctly. Upon detection, ”McRoberts maneuver was performed”and “Shoulder dystocia condition resolved” will be logged in the event log. Once shoulder dystocia isresolved, the fetus continues to be pushed, during the contractions, through the birth canal untilreaching the final position. At the final position, the fetus is released from the birthing mechanism andis ready to be manually delivered.The Suprapubic Pressure option activates the automatic resolution of shoulder dystocia whensuprapubic pressure applied. The right force needs to be applied for at least 5 seconds to resolve thecondition. Upon detection, ”Suprapubic pressure was applied” and “Shoulder dystocia condition resolved”will be logged in the even log. Once shoulder dystocia is resolved, the fetus continues to be pushed,during the contractions, through the birth canal until reaching the final position. At the final position,the fetus is released from birthing mechanism and is ready to be manually delivered.
