Re: Interesting Case
From: Charlie Chambers (ricechaz@me.com)
Sun May 24 12:16:31 2009
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Perhaps, I should clarify. BTW, I think I get the notion that you are
against this idea. No need to belabor the point.
We are not developing a breech induction protocol. We are working on a
protocol for patients who do not have a successful external version,
and who refuse a cesarean section despite being counseled regarding
potential risks of vaginal delivery. The question of induction was
whether we will allow the induction of a patient who declines a
cesarean. We have had the same issue with patients with prior cesarean
refusing transport to another facility for a trial of labor and
refusing repeat cesarean.
This protocol is not a "breech induction" protocol, nor is it meant to
encourage patients to have a vaginal breech delivery.
*************************************************************************
Charlie Chambers
Hood River, OR
--
cchamber@alumni.rice.edu
"No matter where you go...
there you are."
Dr. Buckaroo Banzai
************************************************************************
On May 24, 2009, at 8:54 AM, JD Stewart,MD wrote:
> At Sat, 23 May 2009, Charlie Chambers wrote:
>
>>
>>> Maybe this is the place for the breech induction protocol!
>>
>> Really? Was that necessary?
>>
>
> I apologize for the exclamation point, but there is a ring of truth,
> as
> there would be for an IUFD breech induction...in a VBAC or otherwise.
>
> Aside from the monitoring aspect, the presence of another "Breech
> Induction" protocol at your hospital would come up as a local Standard
> of Care...and this baby wouldn't fit.
>
> Awful/Simply Awful scenario- lost/damaged million dollar bill
> baby/missed ultrasound/ trouble in labor/ 4th degree/ hemorrhage/
> hysterectomy/ blood transfusion/ hepatitis...DVT/stroke./ billion
> dollar
> career in a wheelchair...
>
> and the patient recalls she wanted an amnio but was talked out of it,
> and begged you to do her C/S 2 days earlier...
>
> Which brings us WAY around to the wisdom in the Breech Protocol
> staying
> forever in committee...
>
> --
> JD Stewart, MD
> MFM up all night, every night
> 10 years later..
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Perhaps, I should clarify. BTW, I think I get the notion that you are against this idea. No need to belabor the point.
We are not developing a breech induction protocol. We are working on a protocol for patients who do not have a successful external version, and who refuse a cesarean section despite being counseled regarding potential risks of vaginal delivery. The question of induction was whether we will allow the induction of a patient who declines a cesarean. We have had the same issue with patients with prior cesarean refusing transport to another facility for a trial of labor and refusing repeat cesarean.
This protocol is not a "breech induction" protocol, nor is it meant to encourage patients to have a vaginal breech delivery.
*************************************************************************
Charlie =
Chambers
Hood River, OR
cchamber@alumni.rice.edu
"No matter where you go...
there you are."
Dr. Buckaroo Banzai
************************************************************************
On May 24, 2009, at 8:54 =
AM, JD Stewart,MD wrote:
At Sat, 23 May 2009, Charlie Chambers wrote:
Maybe this is the place for the breech induction protocol!
Really? Was that necessary?
I apologize for the exclamation point, but there is a ring of truth, as
there would be for an IUFD breech induction...in a VBAC or otherwise.
Aside from the monitoring aspect, the presence of another "Breech
Induction" protocol at your hospital would come up as a local Standard
of Care...and this baby wouldn't fit.
Awful/Simply Awful scenario- lost/damaged million dollar bill
baby/missed ultrasound/ trouble in labor/ 4th degree/ hemorrhage/
hysterectomy/ blood transfusion/ hepatitis...DVT/stroke./ billion dollar
career in a wheelchair...
and the patient recalls she wanted an amnio but was talked out of it,
and begged you to do her C/S 2 days earlier...
Which brings us WAY around to the wisdom in the Breech Protocol staying
forever in committee...
--
JD Stewart, MD
MFM up all night, every night
10 years later..
