Re: malpractice questionnaire

From: Raymond Stephen (stephen.raymond@dhhs.tas.gov.au)
Thu Jun 28 09:48:52 2007


It doesn't seem possible for the baby to transfuse the placenta by putting it above the placenta. There is active heart pumping and venous return, and the pressures in arteries and veins are going to stay much the same whichever is higher. If you leave the cord unclamped for two minutes you will be surprised at how little blood is left in the cord, and it seems physiological for the transfer always to be from placenta to baby. After all placental arteries, which lead to the baby, are pumping for a while after delivery.

Steve

-----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Bernard Cristalli Sent: Thursday, 28 June 2007 10:42 PM To: Multiple recipients of list OB-GYN-L Subject: Re: malpractice questionnaire

Right. Don't milk the whole cord, only a bit, the portion you anyway empty before cutting. Just empty it toward the child. Bernard

R. Daniel Braun a écrit : > Just remember that this can put some premies into heart failure.
>
> Dan
>
> On 6/28/07, *Bernard Cristalli* <bcrist@club-internet.fr
> <mailto:bcrist@club-internet.fr>> wrote:
>
> Easy.
> You have to "milk" the cord toward the baby before cutting it.
> That's a most simple autotransfusion. Anyway, when you leave the
> baby on
> the mom's stomach above the placenta it's the child who transfuses his
> placenta.
> BC
>
> ljmidwife@aim.com <mailto:ljmidwife@aim.com> a écrit :
> > So the malpractice carrier is implying that you need to obtain cord
> > blood gases on every baby?
> > That means that the cord must be cut ASAP after the birth to obtain
> > the needed cord section.
> > How do they square this with the emerging research which recommends
> > delaying cord cutting for 2 minutes to allow blood in the cord and
> > placenta to be transferred to the baby's circulation to prevent
> > newborn anemia?
> >
> > It would seem they are requiring you to create a situation that
> could
> > be harmful to the baby.
> >
> > Linda Johnson,
> > CNM
> > www.mothersownbirth.com <http://www.mothersownbirth.com>
> > Temperance, MI
> > 1-866-920-8100
> >
> > "Not to know is bad. Not to want to know is worse.
> > Not to hope is unthinkable. Not to care is unforgivable."
> > --Nigerian saying
> >
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> R. Daniel Braun, MD FACOG(L) CMT
> Professor Emeritus
> Dept. of Obstetrics and Gynecology
> Indiana U. School of Medicine
>
> R. Daniel Braun
>
> "Science without Religion is LAME; Religion without Science is
> BLIND"
> Einstein 1941

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