Re: OB: Bladder Flap flap
From: Charles Chambers (cchamber@gorge.net)
Thu Jul 17 21:17:36 2003
Used to use them all the time. Escapes me the formal name for such a
device. Very helpful, for a baby with very low station or after an
unsuccessful forcep trial.
>---- Original Message ----
From: glen.elrod@elmendorf.af.mil (Glen Elrod MD)
To: ob-gyn-l@dns.obgyn.net
Subject: Re: OB: Bladder Flap flap
Date: Thu, 17 Jul 2003 19:55:36 -0500
>I ran across an instrument on our unit the other day that no one had
>obviously seen in years, labelled as a "head elevator" It looks like
>a
>glorified shoe horn with a handle. It looks perfectly like it could
>be
>placed under a low low head and use the handle to pull the head up
>out
>of the pelvis. Anyone else seen such a contraption?
>
>Glen
>
>At Thu, 17 Jul 2003, DoctorJoe@aol.com wrote:
>>
>>In a message dated 7/17/03 13:04:18, Terrence.Jones@kp.org writes:
>>
>>> Just trying to get the whole picture. The incision is made. The
>arm of the
>>> baby is now handing you its cord. The assistant is able to push
>the head
>>> upward. Suction is broken as the delivering hand meets the
>assistant's at the
>>> vertex. Flexion is accomplished. Despite every effort to elevate
>without
>>> "breaking the wrist" (as mentioned by another - abducting with
>flexing forward and
>>> facing cross-table); rotation when ears are visible; and
>reduction, below the
>>> vtx - there is now an eight cm vertical extension into the
>parametria and the
>>> ureter is now bathed in heme. This is the "apple" to which i'm
>referring. So
>>> - You reach in and grab the legs. Someone says they've seen
>femoral fractures
>>> with this appraoch. You suggest such fractures may be related to
>technique?
>>> Here's where i'm a bit lost.
>>>
>>I remember that they were talking about the various misadventures of
>the
>>stuck head, and I merely commented that instead of going all out to
>get the head
>>UP, you can try to reach up and get the feet and pull the baby out
>that way. I
>>think once you've broken the suction and have a hand down in there,
>you keep
>>on going for it. Some have used a single Barton forcep to lever the
>head out
>>(Megison, Green Journal, few and sundry years ago). Some can stick a
>vacuum on
>>it. Whatever . . . .
>>
>>I was only commenting on the head the is DOWN there and difficult to
>get at
>>anyway. So I guess I was talking about oranges.
>>
>>Joe P.
>
>--
>D. Glen Elrod, Maj, USAF, MC
>Medical Director
>Women's Health Clinic
>Elmendorf AFB, AK 99506
