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Re: Symphysiotomy for Shoulder DystociaFrom: Arthur W W Curtis, Jr. (artcurtis@juno.com)Sun Feb 13 20:31:11 2000
I have never performed a symphysiotomy or Zavanelli (and hope I never am in a situation that desperate), but I trained many years ago with a resident who had performed many in Africa as an alternate for CSection. She described the procedure slightly differently. After a small vertical incision above the symphysis, she takes many rapid scalpel strokes shaving off a very small cartilage each time. The scalpel strokes are taken from the most superficial portion just under the skin, not from the top (cephlad) of the pubis. The pubis separates before the scalpel goes through the symphysis, thus avoiding injury to the urethra. My questions are: 1. While I am terrified of a Zavanelli (what generalist has any experience with this life raft with the sinking Titanic?), I know very little about long term complications of a smphysiotomy on gait, etc. I know that the pelvis is quite unstable for several months, but how many have long term damage. 2. A symphysiotomy probably not an accepted procedure (in the US anyway), whereas a is. To how much risk is the Obstetrician subjecting himself if he were to perform a symphysiotomy? Thanks -- Arthur Curtis, MD FACOG 100 Central Street Worcester, MA 01608 508 795-1850 (w), 508 853-6494 (h) ArtCurtis@Juno.com / AWCurtis@MassMed.org (snipped )
On Sun, 13 Feb 2000 18:23:53 -0600 ENDODOK@aol.com writes:
> Leaving aside for a moment the current academic discussion re:
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