-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Clincial Pelvimetry From: Henry Gregor (henrygregor@yahoo.com) Tue Aug 8 18:41:35 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Jamie: "Re: Uterine size after c-section" Previous message: Joanne Bulley, MD: "Re: DepoProvera for vasomotory symptoms" In reply to: Garry E. Siegel, M.D.: "Clincial Pelvimetry" Next in thread: Stmidwife@aol.com: "Re: Ob: Arrest of dilatation" I think much of what we do is treating the chart and preemptively treating or defending against the retrospectiscope that some potential plaintiff's attorney may bring to the issue much later in the future...not a great reason to do something, but then again, most of us don't do vbac's for the same reason. Given the liability premiums we pay, I have no problem with keeping these thoughts first and foremost in mind on a daily basis. Some of the more useful words of wisdom I heard in training came from a MFM who reminded us boys and girls not to try to push a square peg through a round hole too long. He was a wonderful physician...still is, I assume. Unfortunately (for our country) he no longer practices in the USA...he relocated to New Zealand, where he felt he could do some good, without spending humongous amounts of time each year in depositons re the complicated cases his subspecialty necessarily got him involved in. Obviously many of those cases were foreordained to have less than perfect outcomes and for many in our society, that's just not acceptable. Hank...I'm just sittin' here, not on the Dock of the Bay, but still wastin' time, waitin' for a chart and a lab result to roll in. "Garry E. Siegel, M.D." <garrys@mindspring.com> wrote: Hank: It was anethema in my training not to perform clinical pelvimetry and a clincal EFW pre-induction. I am pretty sure that these are passe, and that someone somewhere has said--just go ahead and induce anyway, as you will be surprised at how wrong you are upfront, i.e. more babies will deliver vaginally than you think. CNMs--do you perform clincial pelvimetry? Are you trained in it? MDs--ditto? In our practice, this patient might not have had a physical examination by the MD, only a chart review/curbside consult pre-induction. Garry At Thu, 3 Aug 2006, Henry Gregor wrote: > >Clinical pelvimetry...independent of any actual medical issue, were there to be an adverse outcome, and were CPD or complication of induction to occur, plaintiff's attorney will definitely have a paragraph in the suit papers calling one and all's attention to the deviation from good clinical practice evidenced by such a disregard for proper pelvic assessment. I knew a university department attending who never failed to provide some such wording on virtually all the plaintiff attorney case reviews she did. > > As she would put it, attention to an entry re pelvic adequacy will save all concerned some depsition time and eliminate at least one paragraph in the attorney's litany of charges of substandard practice. > > Hank > >"Garry E. Siegel, M.D." wrote: > Sue: > >What's the solution? > >I think we would agree that induction with pre-eclampsia at term is >warranted, and if she's not progressing, she's not progressing. > >Her reticence to proceed to a section allowed a fever to develop, and >she didn't progress, got antibiotics, and still had a section. > >Dan, this patient did not have an assessment of her pelvis before >induction. > >Listers, would you expect a CNM or MD to have done so? > >Dan, had I personally assessed her pelvis in the office, and told her >that it was not good, and that the chance of success was poor, I think >she would have looked at me like I was crazy, and then asked why not >try. I have not been successful convincing/selling/arguing/cajoling >patients who are not accepting of honestly given advice and direction, >and, you know, they don't always do what you want/tell them to do. > >Garry > >At Wed, 2 Aug 2006, Stmidwife@aol.com wrote: >> >>Respectfully, that is why they are going to a midwife for midwifery as >>opposed to an Obstetrician to participate in the Obstetrics of 2006. >> >>Sue >> >>In a message dated 8/2/2006 4:19:37 P.M. Pacific Standard Time, >>ob-gyn-l@obgyn.net writes: >> >>You're on the mark, but I truly think that the CNMs are pretty >>supportive and frankly attract those patients who are dissatisfied >>elsewhere, and are unrealistic about hospital based Obstetrics in 2006. >> >>Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > > Next-gen email? Have it all with the all-new Yahoo! Mail Beta. > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Tired of spam? Yahoo! Mail has the best spam protection around Next message: Jamie: "Re: Uterine size after c-section" Previous message: Joanne Bulley, MD: "Re: DepoProvera for vasomotory symptoms" In reply to: Garry E. Siegel, M.D.: "Clincial Pelvimetry" Next in thread: Stmidwife@aol.com: "Re: Ob: Arrest of dilatation"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Jul 2 04:44:36 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.