Re: elective primary section
From: art fougner, md (evsono@pipeline.com)
Fri Mar 2 10:32:08 2001
acog has a political agenda??? LOL
probably simply a f/u to British article previously published.
art
At Fri, 2 Mar 2001, Braun, R. Daniel wrote:
>
>Interesting choice of journal for Steve Gabbe and Gerry Holzman. Did the
>Green J reject it??
>
>-----Original Message-----
>From: evsono@pipeline.com [mailto:evsono@pipeline.com]
>Sent: Friday, March 02, 2001 9:39 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: OB: elective primary section
>
>In tomorrow's Lancet -
>
>Home The Journal Current Issue Correspondence
> Volume 357, Number 9257 03 March 2001
>
> Correspondence
>
>Obstetricians' choice of delivery
>
>Sir--R Al-Mufti and colleagues (Feb 24, 1996, p 544)1 surveyed 282
>obstetric consultants in London to find out the method of delivery they
>would prefer if they or their partners were pregnant for the first time
>in an otherwise uncomplicated pregnancy.
>
>They found that, overall, 17% would choose an elective caesarean
>delivery, including 31% of female and 8% of male obstetricians. This
>choice was based on concern about perineal damage from vaginal delivery,
>risk of injury to the baby, and the desire for an electively timed
>delivery. 68% preferred a caesarean delivery for a cephalic
>presentation with an estimated weight of more than 4*5 kg, and 39% for
>an estimated weight of 4*0-4*5 kg. Al-Mufti and colleagues conclude
>that feelings of obstetricians might influence the way they counsel
>their patients, which raises the question of whether caesarean delivery
>should be offered routinely to all pregnant women. Marsden Wagner (Nov
>11, p 1677)2 reviewed this issue.
>
>Stimulated by Al-Mufti's findings, we surveyed North American
>obstetricians attending the American College of Obstetricians and
>Gynecologists (ACOG) District VIII and IX Meeting held in August, 2000.
>These two districts encompass the states of Alaska, Arizona, Colorado,
>Hawaii, Washington, Oregon, Idaho, Montana, Nevada, New Mexico, Utah,
>Wyoming, and California. They also include American Samoa and Guam,
>and, in Canada, the Northwest Territory, British Columbia, Alberta, and
>the Yukon Territory. Participants at the meeting could respond to
>questions from speakers or from panelists by a handheld audience
>response system. We also collected demographic information.
>
>We could tabulate responses immediately, and provided this feedback to
>the participants. During a panel discussion on the risks and benefits
>of vaginal birth after caesarean delivery, members of the audience were
>asked if they would personally prefer to be delivered by caesarean
>section. Of 117 participants, 46*2% said they would choose caesarean
>delivery. Of note, 56*5% of the male and 32*6% of female obstetricians
>said they would prefer a caesarean section. When asked what route of
>delivery they would personally select for an infant weighing 4*0-4*5 kg,
>70% said they would prefer a caesarean section, and for an estimated
>weight of 4*6 kg or more, 88% would desire a caesarean section. Most of
>the participants were members of single-specialty practices (25%),
>multispecialty group practices (14%), and academic-based practices
>(13%). Nearly 70% were older than 40 years, with most being aged 51-59
>years.
>
>Our survey results support the findings of Al-Mufti and colleagues.
>Nearly half of the obstetricians surveyed would prefer a caesarean
>delivery and, surprisingly, more of the male obstetricians desired
>caesarean delivery. With birthweights of 4 kg or more, at least 70%
>would request a caesarean section.
>
>W Benson Harer Jr, President of the ACOG wrote ". . . a woman's right
>to participate in the decision and to choose to deliver her child by
>caesarean delivery will be respected".3 The patient's choice seems to be
>being supported by obstetricians themselves.
>*Steven G Gabbe, Gerald B Holzman
>
>art
>
>--
>art fougner, md
>
>A series of 1000 cases begins with but a single anecdote.
>
--
art fougner, md
A series of 1000 cases begins with but a single anecdote.
