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Re: Zavanelli's maneuverFrom: Anna Meenan, MD (annam@uic.edu)Sat Jun 10 12:03:53 2000
At Sat, 10 Jun 2000, Eberhard W Lisse wrote: >
>Viewing through the retro-recto-spectroscope makes things easy. el, Folks who promote the all-fours maneuver in the US advocate a hands and knees, not elbow/knee position. The goal is to minimize lordosis of the lumbar spine and maximize the space around the posterior arm and shoulder. When the mom is resting on her elbows, the lumbar spine tends to cave downwards. What I do for shoulder dystocia: McRobert's maneuver first, followed immediately by position change to all-fours (Gaskin Maneuver) if not effective. In this position, there is SO much extra space to reach in and grab posterior arm or shoulder, or rotate the baby if necessary, I just don't mess around with the mom sitting on her sacrum. Ina May Gaskin has produced a videotape of an all-four's shoulder dystocia birth which can be ordered from: Videofarm, 42 The Farm, Summertown, TN 38483.
-- Anna Meenan, MD
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