Re: Get Hematocrit in Vacuum Delivery
From: Joanne Bulley, MD (islesannie@gmail.com)
Sat Mar 17 17:51:13 2007
This is one of those messages that the website garbles - leaves bits and
pieces out of -- I have sent the complaint to the webmaster and to Geff
Klein ... but it still does it - makes it hard to read - as you really
do have to "read between the lines!
Joanne
At Sat, 17 Mar 2007, GIN11153@aol.com wrote:
>
>_http://www.obgynnews.com/article/PIIS0029743707700940/fulltext_
>(http://www.obgynnews.com/article/PIIS0029743707700940/fulltext)
>All babies born by vacuum extraction should have an umbilical cord
> subgaleal
>ng one
>y,
>perinatal medicine, neonatology, and the law.
>crit. …
>It's easy, it's inexpensive, and it gives you a benchmark as to where this
>baby started, so that if it starts behaving abnormally you can easily see
> of obstetrics
>and gynecology at the University of California, Los Angeles.
>Intensive monitoring in the first few hours after birth, including noting
>hese
>e
>before being diagnosed.
>All too often, these devastating bleeds escape notice until the baby is in
>serious danger.
>ntilate
>“The
>can be
>
>one-third of the baby's blood volume.�
>The umbilical hematocrit provides a true baseline for the baby's red blood
>cells; a significant neonatal blood loss may be detected by decreasing
>al bleed,
>Dr. Ross said.
>A subgaleal hemorrhage is a large collection of blood in the soft tissue
>space between the galea aponeurotica and the skull's periosteum. Unlike a
>urs can
>lume.
>Most physicians first became aware of this complication after a 1998 FDA
>ter
>vacuum deliveries. After the FDA advisory, which asked physicians and
>ight in
>just 6 months; 23 of these were subgaleal hemorrhages.
>The American College of Obstetricians and Gynecologists has estimated the
>n
>,000
>� said
>erg.�
>
>after birth. The swelling on the head is soft to firm, fluctuant, and
>eeds,
>there can be hypotonia, hypotension, seizures, and permanent brain injury.
>
>vitamin K, the best method of treatment remains unknown, Dr. Ross said.
>e
>no good data to support any of these options.
>There are no firmly established risk factors for subgaleal bleeds.
>focus on
>vacuum extraction technique: difficult extraction, prolonged vacuum use,
>irection
>of traction.
> cause
>rsity. “I
>have seen many cases [in legal settings] where there was one pull in the
>ed.
>r a
>d
>n't
>follow the rules.�
> “
>extraordinarily difficult.�
> that
>� said Brian
>McKeen, a plaintiff's attorney from Northville, Mich.
>se are
>
> that
>he did everything possible to deliver the baby safely and did it intensely
>
>� he
>said.
>
>Gail Neuman RNC CPHW
>student midwife and student nurse practitioner
>certified high risk OB/OB legal consultant
>Perinatal Nurse Associates
>Santa Ana, CA
>
>.
> Find out more about what's free from AOL at http://www.aol.com.
--
Joanne Bulley, MD, FACOG
Solo gyn
Keene, NH USA
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