Re: Which forceps do you choose/ ventouse
From: R. Daniel Braun (rd.braun@gmail.com)
Sun Mar 5 18:51:43 2006
Hey Joe,
That is the Favorable side of 60, just like me at 67.
Dan
116 Days until retirement, but then Who's counting?
Dan
On 3/5/06, Joe <forcep@intercom.net> wrote:
>
> David: I agree with you totally , even to your forcep selections. Yea,
> I'm over 60. Joe C
>
> David Priver wrote:
> > I agree this is an interesting thread, but rather suspect there's no one
> > commenting who's much on the favorable side of 60. In observing my
> > younger colleagues and their complete antipathy to forceps, I conclude
> > that there is no longer any forceps teaching going on in residencies.
> > This, of course, is a big subject, but would submit that this does a
> > great disservice both to babies, mothers, and the entire field of
> OB. It
> > is sad that we have elected to abandon such a beneficial tool. I
> > slightly disagree with Charlie as regards forceps selection, although I
> > do agree that we were taught that. My experience is that once you
> > becomne familiar and adept at a particular type, you'll do your best
> > work with it regardless of the particulars of the birth. I use only
> > Luikart-Simpsons and Kiellands. The former for everything but rotations
> > from OP to OA. You want to know how to bring back forceps use and cut
> > the CS rate in half at the same time? Very simple: just start
> > reimbursing $500 more for a vag del than a CS. The problem will be
> > solved overnight. (Just kidding; I know that can't happen, but it would
> > be interesting, wouldn't it)?
> >
> > At Sat, 4 Mar 2006, Charlie Chambers wrote:
> >
> >>I think you have to individualize forcep selection for each delivery.
> >>As an example, the amount of molding can dictate use of one style of
> >>forcep over another. I don't believe that it is prudent to use one
> >>forcep for every situation though I've seen it done.
> >>
> >>On Mar 3, 2006, at 9:01 PM, Garry E. Siegel, M.D. wrote:
> >>
> >>>Great thread going.
> >>>
> >>>Sequential use must be approached with tremendous trepidation as
> >>>others
> >>>have said.
> >>>
> >>>I enjoy the Kiwi flat cup, too. Great at sections! Robert, the
> >>>comment
> >>>about placing it posterior is right on! If placed on the flexion point
> >>>and you observe the vector as the patient pushes for just a second,
> >>>the
> >>>head will tell you in which direction to pull!
> >>>
> >>>Kiwi the best thing for a deep transverse arrest? Barton forceps in a
> >>>flat pelvis, but since I've never seen them, I doubt I'll try them.
> >>>Kiellands, on the other hand, sure beat a Kiwi in my hands in that
> >>>situation!
> >>>
> >>>Forcep types?
> >>>
> >>>Tuckers with the Luikhart modification for outlets or lows (if
> >>>within 45
> >>>degrees of OA) in a multip. or unmolded head.
> >>>
> >>>Simpson-Luikharts for lows/outlets in primigravidas.
> >>>
> >>>Our hospital has a set of Luikharts--pelvic curve like Simpsons, but a
> >>>sliding lock--great for the LOA/ROA +2 and lower, and easier to apply
> >>>than Simpsons.
> >>>
> >>>Kiellands superb for OP and OT!
> >>>
> >>>Garry
> >>>
> >>>--
> >>>Garry E. Siegel, M.D.
> >>>Private Practice
> >>>Roswell, GA
> >>
> >>************************************************************************
> >>*
> >>
> >>--
> >>************************************************************************
> >>Charlie Chambers
> >>Hood River, OR
> >>cchamber@alumni.rice.edu
> >>
> >>"No matter where you go...
> >> there you are."
> >>Dr. Buckaroo Banzai
> >>************************************************************************
> >>
> >>************************************************************************
> >>
> >
>
--
R. Daniel Braun
Kinky for Governor
