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Re: fundal pressure From: art fougner, md (evsono@pipeline.com) Fri Aug 25 16:40:26 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Jim Connerth: "Re: MedMal from Would you do it again??" Previous message: ginny lee BSN, SNM: "Re: let's play part 2 (see part one for full story)" In reply to: Eberhard W Lisse: "Re: fundal pressure" What???? clinical judgement??? lol art At Fri, 25 Aug 2000, Eberhard W Lisse wrote: > >The key, to fundal pressure, or Kristellerīs manauver or as they like >to say in Germany, to kristeller, is to select the patients. And of >course to use proper technique. > >I used to like it a lot in my young days. > >Our midwives in Namibia donīt like it, but then we donīt run >continuous monitoring on pushing women. We may be loosing a few by not >doing it, or not, but then they donīt sue in Namibia. There are no >statistics about outcomes, so I really donīt know. > >In any case I stopped doing it long ago. > >Now in Germany, my consultant supervisers like it quite a bit and >order me sometimes to assist them by doing it. > >I like it less, the more I use it. > >However, if the head is on the perineum and she tires and needs one >more push or so (and there decelerates the CTG again) I reckon it is >safer and faster than a vacuum or a forceps. (In any case I donīt do >forceps). > >Even more so on doing a vacuum on a decelerating baby on the pelvic >floor one could consider it, though, I feel that vacuum extraction >should be an extraction. > >The technique bit is important, one can only SUPPORT the push of the >woman, one can not PUSH the baby out. > >To try and do in on mid pelvis or even higher is just showing the >ignorance of the person doing/ordering it. > >If the head doesnīt want to come down it doesnīt want to come down. > >el -- art fougner, md A series of 1000 cases begins with but a single anecdote. Next message: Jim Connerth: "Re: MedMal from Would you do it again??" Previous message: ginny lee BSN, SNM: "Re: let's play part 2 (see part one for full story)" In reply to: Eberhard W Lisse: "Re: fundal pressure"

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