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Re: Spam warning for Namibian Obstetricians From: ainsron (ainsron@sbcglobal.net) Tue Oct 23 11:23:20 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Re: Spam warning for Namibian Obstetricians" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Post tubal ligation syndrome." In reply to: Garry E. Siegel, M.D.: "Re: Spam warning for Namibian Obstetricians" Next in thread: Charlie Chambers: "Re: Spam warning for Namibian Obstetricians" I've never seen any articles referencing it either. Just something I picked up from some of my preceptors during residency and found useful because sometimes my hands are a little big for the incision and rather than extending it I use forceps. Most of the time, a single blade allows the head to slide out easily with fundal pressure and it doesn't leave marks on the face. When I use both blades, the application is no different than a vaginal application, just feel for the fontanels and identify the anterior fontanel and apply them either direct OP or OA. There is sometimes a little bruising or marks left, but I've never seen them to be a problem when explained to the patient, anymore than the vacuum mark after a VE delivery. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Monday, October 22, 2007 6:31 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Spam warning for Namibian Obstetricians I never understood, learned or was properly shown how to use forceps at a section. Any references with pictures? Garry At Sun, 21 Oct 2007, Ronald Ainsworth wrote: > >We used that in residency, but I haven't had one for >years. After I scoop the hand up a short distance, >I'll use a single blade of a Simpson forcep as a "shoe >horn" and get my hand out of the way. Takes up a lot >less room than my hand and works quite well for me. >If that doesn't work, I'll apply the other blade and >deliver with the forceps. > >--- "Garry E. Siegel, M.D." <garrys@mindspring.com> >wrote: > >> In order to avoid extension, I have heard a >> suggestion of using the >> "opposite hand" to elevate the head, and have done >> it some, though it is >> awkward. >> >> I am on the patient's right side, and normally use >> my right hand. >> >> However, to use your left hand, you must turn your >> body to the right and >> almost face away from the patient. The puported >> advantage is that you >> limit your wrist motion and lessen the chance of a >> laceration. >> >> It is very rare that I need the head pushed up; >> perhaps because I use >> Kiellands for deliveries that some might >> section--who knows? >> >> Does anyone use the Murless vector? It is a handy >> tool. >> >> Garry >> >> At Sun, 21 Oct 2007, Dr. John Provatopoulos B.Sc. >> M.D.C.M. F.R.S.C. >> wrote: >> > >> >Nice article and basic technique I use, but if the >> author thinks >> >elevating the head from below is not sometimes >> necessary than he hasn,t >> >done enough sections. Another point not brought up >> is, do not fight the >> >uterus you will lose every time and more likely >> cause an extension, if >> >you have not cut accross the placenta and there is >> no occult cord >> >prolapse then you have loads of time to wait for >> the uterus to relax. >> >Extensions to the uterines have never been an issue >> for me they are easy >> >to repair especially if you make a high tranverse >> incision. Extensions >> >to the vagina are the ones that scare me. >> > >> >-- >> > Take care, John >> > >> >> -- >> Garry E. Siegel, M.D. >> Private Practice >> Roswell, GA >> -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Garry E. Siegel, M.D.: "Re: Spam warning for Namibian Obstetricians" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Post tubal ligation syndrome." In reply to: Garry E. Siegel, M.D.: "Re: Spam warning for Namibian Obstetricians" Next in thread: Charlie Chambers: "Re: Spam warning for Namibian Obstetricians"

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