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Re: macrosomiaFrom: Jason Gardosi (jason.gardosi@nottingham.ac.uk)Wed Jan 17 11:28:10 1996
>What is your first line for SD? Squatting? Yes but preferably women are already in a 'supported squat' on the Birth Cushion. Best to use this from the outset of pushing - squatting may be the midwives' forceps but even better for prevention, i.e. before they are exhausted. Advantages of the Cushion: opens pelvis, aids with pushing (handles) AND allows visualising of perineum.
>If that doesn't work, what >then? The conventional McRoberts on the back does not alter the dimensions of the pelvis (Mahburn J, J Nurse-Midwifery, 1988;33:225-31) and I think that it may make the subpubic angle even smaller, and hyperflexion brings forward the perineum. I too like the 'all fours' - pulling upwards, rare to have to grab an arm. I first saw this done by Ina May Gaskin on the Farm in 1984. The first in a line of good midwives who taught me about normal childbirth.
>My student would very much like to see your paper on = symphisiotomy. If you mean the chapter by Roosmalen, I'll try to dig it out - send me your address.
>I am much enjoying this exchange of ideas.
>Jude Me to! And here again an excerpt from your last post:
>eJ8+IhgRAQaQCAAEAAAAAAABAAEAAQeQBgAIAAAA5AQAAAAAAADoAAENgAQAAgAAAAIAAgABBJAG AEwBAAABAAAADAAAAAMAADADAAAACwAPDgAAAAACAf8PAQAAAFkAAAAAAAAAgSsfpL6jEBmdbgDd AQ9UAgAAAABvYi1neW4tbEBsaXN0c2Vydi5iY20udG1jLmVkdQBTTVRQAG9iLWd5bi1sQGxpc3Rz ZXJ2LmJjbS50bWMuZWR1AAAAAB4AAjABAAAABQAAAFNNVFAAAAAAHgADMAEAAAAeAAAAb2ItZ3lu LWxAbGlzdHNlcnYuYmNtLnRtYy5lZHUAAAADABUMAQAAAAMA/g8GAAAAHgABMAEAAAAgAAAAJ29i Somebody else who uses Microsoft Mail might know what does this. For what its worth, it was not a feature of your earlier postings. At first I thought you were just getting steamed up about something and had switched to a rare dialect.... :-) Jason jason.gardosi@nottingham.ac.uk OB/GYN, Queen's Medical Centre University of Nottingham, UK
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