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Re: The 'Infamous' Ina May Gaskin From: Anna Meenan, MD (annam@uic.edu) Tue Sep 26 09:35:32 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Robert J Woolley: "license" Previous message: O'Grady, Patrick MD: "Defination of shoulder dystocia" In reply to: Joanne Bulley: "Re: Thin Prep" At Tue, 26 Sep 2000, Braun, R. Daniel wrote: > >This is one of the problems with shoulder dytocia. There is no good >objective definition. One accoucher's spont. Vaginal Delivery is another's >Shoulder Dystocia. > >Dan > I found a definition when I wrote my article for the Journal of Family Practice. I can't recall the source and I'm not in my office right now. Basically it was "any delivery in which maneuvers other than lateral traction and episiotomy are required to deliver the shoulders." I suspect that the higher incidence of shoulder dystocia at the Farm may be partly related to the low c-section rate. (Babies born by c-section do not have shoulder dystocias, though they may in rare instances get brachial plexus palsies). I have seen the Shoulder Dystocia video from the Farm and I would call it a definite shoulder dystocia--positive turtle sign, purple baby head, the works. Why is McRobert's maneuver considered a shoulder dystocia maneuver if we are going to say that any shoulder dystocia that resolves with McRoberts maneuver was not a shoulder dystocia in the first place? Obviously it is a matter of degree. There are bad shoulder dystocias and there are not-so-bad shoulder dystocias. The point of the all-fours maneuver is that ALL of the babies in the registry so far were delivered with an almost complete absence of morbidity. -- Anna Meenan, MD, FAAFP Next message: Robert J Woolley: "license" Previous message: O'Grady, Patrick MD: "Defination of shoulder dystocia" In reply to: Joanne Bulley: "Re: Thin Prep"

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