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Charles Edwin Woods (1888-1946) was an American obstetrician and gynaecologist.

Woods is eponymously remembered for his descriptions and publications of the Woods Screw Manoeuvre, a technique used in the management of shoulder dystocia.


Biography
  • 1888 – Born
  • 1910 – MD, Indiana University School of Medicine
  • Practices in Indianapolis until 1917
  • 1917-1918 – Swerved with the Army Medical Corp in France
  • Chief of the maternity staff at Rockville Center Hospital; member of staff at the North Country Community Hospital, Glen Cove; Department of Obstetrics, Nassau Hospital; Meadowbrook Hospital in East Meadow, Hempstead, NY
  • President of the Nassau County Medical Board
  • Died on August 14, 1946 of a heart attack, aged 58

Medical Eponyms
Woods Screw Manoeuvre (1943)

The Woods “screw” manoeuvre is an obstetrical internal rotation or foetal manipulation manoeuvre performed in cases of shoulder dystocia where the McRoberts manoeuvre has failed. The practitioner pushes the posterior shoulder through a clockwise 180-degree arc by applying pressure on the anterior surface of the posterior shoulder.

1940 – Charles Edwin Woods (1888-1946) gave a series of presentations, using wooden models, to manage the problem of shoulder dystocia using a principle of physics. Woods demonstrated that if the anterior foetal shoulder becomes impacted behind the symphysis pubis, direct propulsive or traction forces will not overcome the dystocia.

Difficulty in the delivery of shoulders, usually comes as a complete surprise. We have no warning, a real emergency exists, and the minutes we have in which to make a safe delivery usually pass much faster than expert help can arrive. 

Woods screw presentation 1940
New York State Journal of Medicine. 1940

1943 – Charles Edwin Woods refined his approach and published A principle of physics as applicable to shoulder delivery in the American Journal of Obstetrics and Gynecology.

The passage of a baby through the birth canal is, in the vast majority of cases, an engineering problem. By applying a law of physics applicable to the screw, we find that most of our difficulty is due to a “crossed thread” or improper inclination of some part of our screwlike object.

He likened the relationship between the foetal shoulders and the symphysis, sacral promontory and coccyx to the the threads of a screw.

After the head has been born the shoulders of the baby resemble a longitudinal section of a screw engaged in three threads, the ‘pubic thread’, the ‘promontory thread’ and the ‘coccyx thread’. Any pulling on the baby’s neck or axilla is mechanically incorrect because it violates a simple, well-known law of physics applicable to the screw.

Woods documented in a series of 16 figures, his corkscrew method for breech and vertex delivery as well as outlining ways to overcome potential complications

A downward thrust is made with the left hand on the buttocks of the baby. At the same time two lingers of the right hand, on the anterior aspect of the posterior shoulder, make gentle clockwise pressure upward around the circumference of the arc to, and past, twelve o’clock. The posterior shoulder is now delivered.

With pressure applied downward from above with the left hand the two fingers of the right hand make gentle counter-clockwise pressure upward around the circumference of the arc and past twelve o’clock, and the remaining shoulder is delivered.

Woods Screw Manoeuvre (1943)
Fig 5, Fig 6. A wooden manakin with shoulders so large that they cannot be delivered by pulling. There is not enough room to force the hand under the “pubic thread” in an attempt to pull the anterior shoulder out. There is not enough room to force the hand into the crowded hollow of the sacrum. There is, however, ample room to insert two fingers between the baby’s head and shoulder without touching the maternal parts except at the labia. Woods 1943

Woods Screw Manoeuvre: Johns Hopkins Medicine


Major Publications

Eponymous Shoulder Dystocia management techniques

References

Fourth-year MBBS student at Curtin Medical School. Conducting penultimate year of medicine with the Rural Clinical School of WA in Kalgoorlie. Passionate about women's health, emergency medicine and rural health care.

Graduated from Cardiff Medical School in 2017 with MBBCh and BSc in Psychology and Medicine. Currently working as a doctor in the emergency department at Sir Charles Gairdner Hospital in Perth, Australia.

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