Re: VBAC, Three previous CS.
From: charlie chambers (cchamber@mnic.net)
Sun Jan 30 10:45:41 2000
on 1/30/00 11:09 AM, Malcolm Griffiths at obsdoc@doctors.org.uk wrote:
> I delivered women with previous CS>1. I have supervised trials in wome with
> up to five previous CS (never had a delivery vaginally with more tha two CS,
> but the women who try and fail are happy to have tried. Providing
> supervision is adequate and you have spontaneous labour I'm happy to try.
>
> As with many other listers I have given up pelvimetry (for any indication)
> years ago. The predictive value of the test is appalling. It simply is the
> case that if any of the measurments are small then you go for CS - hence
> small measurements predict CS!
>
> As for "el" - where is your sense of infomed choice and consent?
>
> Malcolm GRIFFITHS, Ob/Gyn E-mail obsdoc@doctors.org.uk
> Dept of Obs & Gynae +44(0)1582-497533 (Sec) 21, School
> Lane,
> Luton & Dunstable Hospital, +44(0)1582-497376 (Fax/me) Eaton Bray,
> Lewsey Road, +44(0)1525-222849 (Home)
> DUNSTABLE,
> LUTON, LU4 0DZ.. +44(0)1525-222643 (Fax)
> Beds., LU6 2DT..
>> ----- Original Message -----
> From: Braun, R. Daniel <rbraun@iupui.edu>
> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net>
> Sent: Sunday, January 30, 2000 3:19 PM
> Subject: RE: VBAC, Three previous CS.
>
>> An interspinous of 9 cm. is a little on the small side. A subpubic angle
> of
>> 68 degrees????? I was taught that 85 was small.
>>
>> Dan
>>
>> R. Daniel Braun, MD FACOG
>> Clinical Professor
>> Department of Obstetrics and Gynecology
>> Indiana U. School of Medicine
>> Indianapolis, IN 46202
>>
>> OBGYN.net
>> International Representative for United States
>>
>> Certified AllExperts Expert
>> Check out my bio/ratings page!
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>>
>> -----Original Message-----
>> From: dpmohen@gateway.net.au [mailto:dpmohen@gateway.net.au]
>> Sent: Saturday, January 29, 2000 7:24 PM
>> To: Multiple recipients of list OB-GYN-L
>> Subject: VBAC, Three previous CS.
>>
>> A woman who has had three previous caesarian deliveries, the first
>> following failure to progress in labour with an occipito posterior
>> position in labour induced at term for hypertension and the other two
>> elective, wishes to attempt a vaginal delivery. Xray pelvimetry after
>> her first showed an android pelvis, with a 9cm interspinous diameter and
>> a subpubic angle of 68degrees. To what level of risk is she exposing
>> herself and her child? Is her ambition reasonable?
>>
>> --
>> dp mohen
>>
>
I've always liked the adage with VBAC's of only two choice, easy vaginal
delivery or easy cesarean section. I believe it to be a good philosophy when
approaching labor.
--
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Charlie Chambers, MD "No matter where you go...
1765 Denmark Pl there you are."
Owatonna, MN 55060
(507)444-9716 Dr. Buckaroo Banzai
cchamber@alumni.rice.edu
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