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Re: OB: Full dilatation From: Braun, R. Daniel (rbraun@iupui.edu) Thu Dec 4 04:32:06 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Len2976@aol.com: "Re: Forceps--was Full dilatation" Previous message: Garry E. Siegel, M.D.: "Re: OB: Full dilatation" Maybe in reply to: Garry E. Siegel, M.D.: "OB: Full dilatation" The latest ACOG "practice Bulletin" on operative Vaginal Delivery was in 2000 I think. Anything ab ove a +2 station is indeed a mid forceps. However that is +2 of 5 NOT +2 of 3. This is not a change from the one before that which I think was in '96 Dan -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Wednesday, December 03, 2003 9:47 PM To: Multiple recipients of list OB-GYN-L Subject: Re: OB: Full dilatation Well, John, it is interesting that you mention forceps, as I was brought up (and I know others my vintage or older) to use them a good bit. That said, I simply haven't needed to in a while. Forceps operations are the most professionally satisfying operation that I perform in Obstetrics, if not for anything that I do. There is no one else but an Obstetrician who can do this (sorry any FPs out there, or old GPs, I suppose). Currently, speaking for myself, I am comfortable doing operative deliveries with forceps from +2 or lower, and usually we're talking OT and maybe OP. In the current (1989 ACOG) definitions, those are low forceps with rotation (assuming rotating the OP to OA). To me, anything above +2 is a no-no, and by the ACOG definitions, those are mid-forcep operations only to be undertaken in emergencies while preparing for a section. This same operation (i.e. OP to OA, or OT at +2) was a mid-forceps when I learned it. So, I'm NOT doing any mid-forceps, and others probably aren't either, by current US definition. Also, FWIW, my criteria are the same for vacuums and forceps, meaning I don't try to deliver a +1 with a vacuum which I wouldn't use forceps. So, as one of my fine mentors (Jack Huddleston) always said, if you had to send me to a desert island with only one set of forceps, they would be Kielland's :). Garry > >Garry do you think there is anyone left at ACOG who knows how to do a >mid-forceps, 3 hrs for a nullipara or 2 hrs for a multip especially if >they are pushing is starting to get into cruel and unusual punishment >territory. > >-- > Take care, John > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Len2976@aol.com: "Re: Forceps--was Full dilatation" Previous message: Garry E. Siegel, M.D.: "Re: OB: Full dilatation" Maybe in reply to: Garry E. Siegel, M.D.: "OB: Full dilatation"

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