Re: trapped vertex at c-section
From: Bernard Cristalli (bcrist@club-internet.fr)
Thu Jun 10 04:38:11 2004
Dan,
You can use the forceps with the blades directed downwards.
More powerful than the gloved hand in the vagina.
--
Bernard Cristalli MD AMACOG
AIHP - ACCA
Paris France
http://www.CliniquedelEssonne.fr
http://www.obgyn.net/corresp/cristalli.htm
http://www.gyneweb.fr
'64 Mk2 3.8
> De : "Braun, R. Daniel" <rbraun@iupui.edu>
> Répondre à : ob-gyn-l@obgyn.net
> Date : Thu, 10 Jun 2004 01:06:19 -0500
> À : Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
> Objet : RE: trapped vertex at c-section
>
> I have used it, but you have to get the head out of the pelvis before
> you put it on.
>
> Dan
>
> "Sound is like water. If you drill one hole in the wall the sound will
> leak right through."
>
> - JAY BRAUN, a band member by love, a soundproofer by necessity.
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod
> Glen Maj 3 MDG/SGOB
> Sent: Wednesday, June 09, 2004 11:23 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: RE: trapped vertex at c-section
>
> Have you ever used the Murless forcep? I've seen them lying around the
> unit and thought about using them but I've never had a problem with the
> gloved hand in the vagina, either.
>
> Glen
>
> -----Original Message-----
> From: Braun, R. Daniel [mailto:rbraun@iupui.edu]
> Sent: Wednesday, June 09, 2004 7:27 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: RE: trapped vertex at c-section
>
> I have probably been very lucky, but so far (knock on wood Thunk thunk)a
> gloved hand in the vagina has always been able to push the head back up
> out of the pelvis.
>
> Dan
>
> "Sound is like water. If you drill one hole in the wall the sound will
> leak right through."
>
> - JAY BRAUN, a band member by love, a soundproofer by necessity.
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of freda
> Sent: Wednesday, June 09, 2004 7:26 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: re: trapped vertex at c-section
>
> At 20:15 -0500 6/9/04, freda wrote:
>> Have been asked for opinion about a bad obstetrical outcome following
>> the inability of the Ob to free the vertex from the pelvis during a
>> cesarean. Please email me privately if you have knowledge of any cases
>> similar to this. The defense needs examples of other cases to show
>> that this is a rare but not unique event.
>>
>> Thanks,
>> Richard Kaplan, MD FACOG
>> Greensboro, NC
>
> In the "Tenth Annual Report of the Obstetrical Review Committee for
> the Office of the Chief Coroner for Ontario" Dr Karen Acheson,
> Jan-Dec 2003
>
> "Neonate died of complications of birth trauma. Postmortem found
> multiple skull fractures and widespread subgaleal hemorrhage.
>
> "The labour was long, and an emergency CS was performed. The placenta
> was anterior and had to be cut to reach the fetus. The baby's head
> was firmly wedged in the pelvis and manual manipulation was required
> to extract it, prolonging the period in which the baby was relaying
> on a traumatized placenta for oxygen. The multiple fractures were
> likely sustained as a consequence of the force applied during the
> procedure. Measures were taken in the form of uterine relaxants and
> help from below to assist in the delivery. "
>
> This report is a form of quality assurance. Cases are reviewed by a
> multi-disciplinary group and recommendations are written. this is
> sent to all OB providers in the province.
>
> In the above case, the recs included informing peds of the special
> circs associated with the birth. Also, to consider hem shock when
> resucitating pale newborns.
> --
> Freda Seddon
>
> Community Midwife
> Toronto, Canada
>
