Re: external cephalic version
From: Ronnie Martinez Brignardello (ronniem@entelchile.net)
Sun Apr 30 19:55:35 2000
and what about a indian dance whit a voodoo mask ??
ronnie
Efrain Ramirez wrote:
> It's good for me anyhow :-) - besides lawyers, patient and relatives.
>
> >At Sat, 29 Apr 2000, Jim Connerth wrote:
> >
> >Ahh-good question! Has it been established that maternal oxygen is beneficial
> >to fetal unit?
> >
> >Ronnie Martinez Brignardello wrote:
> >
> >> why oxygen?
> >>
> >> ronnie
> >>
> >> Steve & Eryl Raymond wrote:
> >>
> >> > On 27 Apr 2000, at 21:35, Kevin D. Dew MD wrote:
> >> >
> >> > > 1. What gestational age?
> >> > > 2. How soon afterward do you deliver?
> >> > > 3. What do you use to relax the uterus?
> >> > >
> >> > > Trying to get an idea of what people are doing.
> >> > >
> >> > The WHO Reproductive Health Library states the following in a
> >> > meta-analysis of trials involving ECV:
> >> >
> >> > Conclusions: There is compelling evidence that ECV attempt at
> >> > term materially reduces the chance of non-cephalic birth and
> >> > Caesarean section. The randomised trials to date are too small to
> >> > address the question of the risk of ECV at term, though published
> >> > uncontrolled series indicate that this is small. In individual cases,
> >> > the risk of ECV needs to be weighed against the current and future
> >> > risks of continued breech presentation to mother and fetus.
> >> >
> >> > As a result of reading this our policy has been established as
> >> > follows:
> >> > 1. Attempt ECV only if breech presentation at 37/40.
> >> > 2. If unsuccessful then take to a CTG machine and give Ipradol
> >> > 5mcg. (or another tocolytic) i.v. Within three to five minutes
> >> > attempt ECV again.
> >> > 3. Run CTG for five minutes if unsuccessful, 20 minutes if
> >> > successful.
> >> >
> >> > My experience has been that a more than 50 % success rate can
> >> > be achieved with this procedure. It is true that there are occasions
> >> > where the procedure results in profound distress in the baby. You
> >> > need to be ready to do a C/S if the FH doesn't respond to turning
> >> > on the side and/or oxygen administration. This is excessively rare.
> >> > Had to do it once in 20 years. Timing of delivery is no different then
> >> > from your standard cephalic presentation.
> >> >
> >> > Steve Raymond
>
> --
> "The things you learn after you know everything are the important ones"
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