delivery may also be facilitated by delivery of posterior
arm (Evidence level III, RCOG) (3). The Jacquimier
manoeuvre effectively reduce of 20% the bisacromial diameter
(6), allowing the fetus to drop into the sacral hollow,
freeing the impaction of the anterior shoulder under
the symphysis (52). To perform the maneuver, pressure
should be applied by the delivering provider at the antecubital
fossa to flex the fetal forearm. The arm is subsequently
swept out over the infant’s chest and delivered
over the perineum (6). The fetal trunk will either follow
directly or the arm can be used to rotate the fetal trunk
to facilitate delivery (3). This manoeuvre may be indicated
particularly when the mother is large (65) (Evidence
level III, RCOG) (3), although grasping and pulling directly
on the fetal arm and applying pressure onto the
midhumeral shaft may cause humeral fracture (66),
even though these injuries typically heal without any
long-term morbidity (47).