Re: Arrest of Dilation
From: Jamie (ajfields@pine-net.com)
Fri Aug 4 13:52:31 2006
A hgb of 8, while it is not life threatening and will right itself given
enough time and a healthy patient, does make one feel pretty miserable.
The postpartum woman with a hgb of 8 might disagree that it doesn't
qualify as morbidity.
At Fri, 04 Aug 2006, Dr Eberhard Lisse wrote:
>
>Ashley,
>
>I would suggest if one estimated maternal morbidity and mortality
>associated with practices unrelated to delivery such as being run over
>by a car, stabbed, shot or killed dead through other ingenious means,
>one would find that the risk for a C/S is so much lower than any of
>these practiced enthusiastically that they are negligible, in particular
>if the C/S is done electively.
>
>And by the way, this morbidity crap is quite subjective, patient or
>observer, for example fever post partum, managed well, and having no
>sequelae don't bother most of my patients none.
>
>Or blood loss. I like transfusions as much home deliveries, whether it's
>a difficult hysterectomy, vaginal delivery or bypass, I think I have
>transfused 10 units of packed cells in the last 6 years for diagnoses
>other than Malaria, so, if they end up with an Hb of 10 or 8 makes no
>difference in management.
>
>el
>
>on 8/4/06 1:50 AM D. Ashley Hill said the following:
>> I would add that the data suggesting an increase in maternal morbidity
>> with cesarean delivery has been disproven with regards to elective
>> cesareans. One cannot compare patients having an elective cesarean with
>> a cesarean after a long labor. In fact, there is some evidence to guide
>> us from a large series of patients in Nova Scotia (2003), which I
>> abstracted below from Medline. There are other studies supporting this
>> premise. Using these data, one could conclude that the informed consent
>> process should include information that having labor and ending up with
>> a cesarean is a setup for the most morbidity, as a physician patient
>> explained to me after requesting an elective cesarean. As Henry
>> suggests, it's tough to give informed consent about vaginal delivery,
>> assisted operative delivery, and cesarean delivery because of all the
>> variables with mom, the labor process, and the baby.
>
>--
>Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar)
>el@lisse.NA el108-ARIN / * | Telephone: +264 81 124 6733 (cell)
>PO Box 8421 \ / Please send DNS/NA-NiC related e-mail
>Bachbrecht, Namibia ;____/ to dns-admin@na-nic.com.na
>
--
JFields, RN, BSN
|
|
