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Re: episiotomy and shoulder dystocia wasits effects on perineal body/external anal sphinctor From: Harvey S. Marchbein, M.D. (hmarchbein@worldnet.att.net) Sat Apr 26 23:14:58 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Robert J. Woolley: "morbidity of sphincter damage" Previous message: DoctorJoe@aol.com: "Re: Closure of evisceration" In reply to: Garry E. Siegel, M.D.: "Re: episiotomy and shoulder dystocia wasits effects on perineal body/external anal sphinctor" Next in thread: Margie Dacko: "Re: episiotomy and shoulder dystocia wasits effects on perineal" Reply: Margie Dacko: "Re: episiotomy and shoulder dystocia wasits effects on perineal" At Sat, 26 Apr 1997, Garry E. Siegel, M.D. wrote: > >Garry the chickenhearted (right out of Monty Python) does not believe >that an episiotomy makes a difference in a shoulder dystocia unless you >need it to get your hand in the vaginal to maneuver. Usually, that >would be in a primip, but not in a multip. > >However, I will always cut one (probably a small one), so the >prosecuting attorney can't harass me as to why I didn't. > >I'm being honest on this one--who needs the aggrevation of not making an >epis and then wondering! Fear not, o' wise one! Remember, the lion in "The Wizaed of Oz" was brave but needed a badge of bravery. May you never have one by some slime-bucket attorney asking yo why you didn't do that "unnecessary" episiotomy. Would that we could all get four hands into the vagina of a patient having an 11 pounder like Margo! I agree with those who said episiotomies should be reserved for times when you need the room for manipulations. Definitions aside, if I don't need to get my hands in and do a rotation (for which my *petite* hands need extra room), I don't usually call it shoulder dystocia. (Refer back to my heart pumpin' post). -- Harvey Harvel the Marvel Harvey S. Marchbein, M.D. FACOG, FACS President, Nassau Obstetrical and Gynecological Society, Inc. OBGYN.net U.S. Representative, New York http://www.obgyn.net/states/bios/marchbein.htm Private practice, Long Island, N.Y. ********************************* It's better to be lucky than to be smart. Even smart people can have an off day! ********************************* Next message: Robert J. Woolley: "morbidity of sphincter damage" Previous message: DoctorJoe@aol.com: "Re: Closure of evisceration" In reply to: Garry E. Siegel, M.D.: "Re: episiotomy and shoulder dystocia wasits effects on perineal body/external anal sphinctor" Next in thread: Margie Dacko: "Re: episiotomy and shoulder dystocia wasits effects on perineal" Reply: Margie Dacko: "Re: episiotomy and shoulder dystocia wasits effects on perineal"

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