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Re: obstructed labourFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Sun Dec 30 05:51:36 2007
At Sun, 30 Dec 2007, =?utf-8?q?Dr. Bülent Potur?= wrote: >
Does any listmate has any experience or any working knowledge to suggest
to relax a tight uterus around the fetus during cesarean section?
> Any general anesthetic is the gold standard for uterine relaxation; as most c-sections are done with spinal or epidural a G.A at least initially is not an option, most anesthetists feel comfortable giving slow I.V. push nitro glycerin for acute uterine relaxation for transverse lies or after coming heads on breach c-sections, I have used it on dozens of occasions with very good results. I have had difficult extractions with classical incisions in the face of tetanic contractions, all you can do is wait for the nitro glycerin to work and of course if your patient's runs out extend the incision with bandage scissors and/or scalpel. I used ritodrine in this setting it is no longer available, have also used nefidipine (adalat) with good results, usually use nitro glycerin because that’s what’s always available with the anesthesia cart.
--
Take care, John
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