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Re: More posterior than you thinkFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Sun Jan 6 05:16:04 2008
The mother of the infant who developed the subgaleal haematoma was a nullipara who had a prolonged second stage of labour lasting 170 minutes and who had been pushing for about 90 minutes without significant descent of the head. Fetal position was occipitotransverse and the station of the head was assessed to be at the level of the ischial spines. The vacuum cup was applied correctly to the fetal scalp and slow descent was achieved over eight contractions. Duration of the vacuum extraction was 21 minutes and the birth was complicated by shoulder dystocia. The infant's birthweight was 4620 grams. Sounds like one of my typical last minute consults. http://www.clinicalinnovations.com/literature/VaccaArticle.pdf
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Take care, John
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