Re: OB: What would you do
From: Andrew Folley (agfolley@hotmail.com)
Tue Aug 29 11:59:03 2006
Garry
I would deliver her from below providing heartones remian stable. Take her
to the OR and have her keep pushing. Have the pipers available and the NICU
Team.
andrew
>From: garrys@mindspring.com (Garry E. Siegel, M.D.)
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: Re: OB: What would you do
>Date: Mon, 28 Aug 2006 11:05:48 -0500
>
>A 32 week primigravida, and the diagnosis of breech was not made until
>she was pushing. I doubt that the head turned; rather, the diagnosis
>was not made until later.
>
>Hard to believe? Give me a break, please.
>
>Garry
>
>At Mon, 28 Aug 2006, Dr Eberhard W Lisse wrote:
> >
> >I am not sure I am following you,
> >
> >A PRIMIGRAVIDA arrives at your facility in labour (7 cm with bulging
> >membrans, you examine her (presumably a little while later) and at 9
> >cm you diagnose VERTEX. Then you go back to sleep (which in itself, at
> >9cm, I find remarkable) and you are wanting to tell us that the well
> >enganged head (you ruptured membranes) has turned? I find this all
> >hard to believe.
> >
> >I reckon you can only do a C/S because she doesn't seem to be able to
> >push properly, even if the buttocks are crowning, but you'll find
> >it'll be difficult to get hold of the baby and will end up with
> >massive (extension of the) uterine incision.
> >
> >Is this the one who asked at commencement of ANC whether you have
> >malpractice insurance? :-)-O
> >
> >el
> >
> >In message <200608280214.k7S2EhN26597@dns.obgyn.net>, Garry E. Siegel,
>M.D. wri
> >tes:
> >> 33 YO P0 at 32w4d presents in PTL at 7 cm/Bulging BOW.
> >>
> >> On my exam, AROM--9 cm., vertex--just got epidural.
> >>
> >> Called to delivery from sleep--+3 station, and after a couple of
>minutes
> >> and very good pushes, she's +4, and, by the way, frank breech.
> >>
> >> Her epidural is such that between pushes the presenting part recedes
> >> inside the introitus. I do think that there is time to do a section,
>if
> >> desired.
> >>
> >> Your thoughts. . .
> >>
> >> Garry
> >>
> >> --
> >> Garry E. Siegel, M.D.
> >> Private Practice
> >> Roswell, GA
> >>
>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
