Re: How to deliver
From: Bernard Cristalli (bcrist@club-internet.fr)
Wed Jan 30 15:35:44 2002
Dühssen procedure.
--
Bernard Cristalli MD AMACOG
AIHP - ACCA
Paris France
Bernard.Cristalli@CliniquedelEssonne.fr
http://www.CliniquedelEssonne.fr
http://www.obgyn.net/corresp/cristalli.htm
http://www.gyneweb.fr
> De : "Braun, R. Daniel" <rbraun@iupui.edu>
> Objet : RE: How to deliver
>
> BTW, there is such a thing as a vaginal cesarean. I have seen it described
> in books. It would not be done for CPD though only for things like PP etc
>
> R. Daniel Braun, MD
>
> Laws to suppress tend to strengthen what they would prohibit. This is the
> fine point on which all the legal professions of history have based their
> job security.
> Bene Gesserit Coda
>
> -----Original Message-----
> From: garrys@mindspring.com [mailto:garrys@mindspring.com]
> Sent: Tuesday, January 29, 2002 9:08 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: OB: How to deliver
>
> OK, here's one to kick around a bit.
>
> 25 YO P1001 at 16 weeks, good dates, in for a routine visit. At her
> first visit, with our CNM (who does office only), she described a
> difficult vaginal delivery with a shoulder dystocia, of a 9 pound, 2
> ounce baby, who went home with her 3 days later, with no sequelae, birth
> trauma, etc. The patient used the word, "Vaginal C/Section," duly
> written onto our prenatal by our office RN. The patient was not
> diabetic in that pregnancy.
>
> At the visit, the patient told the CNM that she was told that she should
> have C/Sections in future pregnancies, and that apparently is how the
> issue was left. 1 hour glucose screening was done, and was 111 mg/dl (I
> think that those are the right units).
>
> Well, I just saw her and went over the above, and requested records (but
> likely the progress notes/written delivery note will not have the detail
> needed). I told her that I would like to review things, once available,
> and then discuss options.
>
> Would you:
>
> 1. Say "screw it" and just plan a section at term without labor.
> 2. Try to press her into a vaginal attempt, carefully conducted, or
> course.
> 3. Hope the records come, review them, and then deal with it. That
> said, the basic choices will still be "1" or "2".
> 4. Make a tentative plan to visit this near term, after a clinical
> and/or ultrasonographic assessment of EFW, as well as a cervical
> examination.
> 5. Have your partners deal with it :).
> 6. Other: please expand
>
> Garry
> --
> Garry E. Siegel, M.D., F.A.C.O.G.
> Roswell, GA
> Private Practice
>
