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Re: ventouse From: Raymond Stephen (stephen.raymond@dhhs.tas.gov.au) Sun Mar 5 16:04:22 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Charlie Chambers: "Re: Fundal Pressure" Previous message: Raymond Stephen: "Re: Fundal Pressure" Maybe in reply to: GA12L@aol.com: "ventouse" Next in thread: Raymond Stephen: "Re: ventouse" While all that has been said here is true, it should not be forgotten that the difficulty at Caesar of delivering a head from a pelvis into which it has been pulled by a failed vacuum is not inconsiderable. It is probably the failed vacuum that is the damaging process, not the efforts to deliver after the vacuum has failed. Steve ________________________________ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of R. -- ________________________________ Daniel Braun Sent: Saturday, 4 March 2006 4:16 AM To: Multiple recipients of list OB-GYN-L Subject: Re: ventouse AMEN!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Dan On 3/3/06, D. Ashley Hill <dahmd@cfl.rr.com> wrote: I mean no disrespect, but I think you are standing way, way out on a limb when you combine operative delivery techniques like a forceps following a vacuum, even if it's to "lift out" the baby. The most recent ACOG technical bulletin advises against it, primarily based on Towner's paper (referenced below) that showed the highest incidence of intracranial injury occurred after use of sequential techniques. I suppose one could consider it if there is a serious risk of maternal morbidity or mortality with a cesarean, but only after very detailed informed consent. The legal folks I have listened to very strongly discourage sequential operative instruments. G-d forbid the baby have an intracranial injury, you would be facing the ACOG bulletin and good evidence that you should have just taken her to the operating room for a cesarean. Best wishes. Towner D, Castro MA, Eby-Wilkens E, Gilbert WM. Effect of mode of delivery in nulliparous women on neonatal intracranial injury. N Engl J Med 1999; 341:1709-1714. Ashley -- R. Daniel Braun Kinky for Governor Next message: Charlie Chambers: "Re: Fundal Pressure" Previous message: Raymond Stephen: "Re: Fundal Pressure" Maybe in reply to: GA12L@aol.com: "ventouse" Next in thread: Raymond Stephen: "Re: ventouse"

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