Re: Thanks for CME - breech/breech twins

From: Bernard Cristalli (bcrist@club-internet.fr)
Wed Mar 8 13:09:44 2006


And if you never saw, nor did a vaginal breech (supposed to be safer) you're unable to manage that and you're shot down by the same lawyers. Vaginal breech is a procedure you have to know (every part of it) unless every pregnancy ends on the exact due date and never before. BC

Joe Cutchin a écrit :

> Way to go ,Jane. Wish you were in an observation delivery room with
> 100 lawyers looking on so they could realize the situations we find
> ourselves in at times. Joe C
>
> Jane Helwig, MD wrote:
>
>> It is too bad we don't get CME credit for this forum because I have
>> learned more here than at the expensive courses we do get credit from.
>>
>> This morning at 1am a 31-weeker, twins, no prenatal record, arrives by
>> ambulance at my hospital (level 1 nursery). Exam shows bulging bag and
>> small parts in the vagina. I discover the L&D ultrasound is broken!
>> Substitute ultrasound brought from ER and they are both complete
>> breeches. By now 2 pediatricians have been summoned and the OR crew is
>> on the way and she is pushing. What should I see through the bag but a
>> funic presentation. I decide the better part of valor would be to
>> deliver en caul and all in the room send prayers to keep that bag
>> intact! It stays intact and a 1500g baby is born with membranes breaking
>> at delivery. Second baby, 2100g, born a few minutes later, required
>> Mauriceau-Smellie-Veit to maintain head flexion and suprapubic pressure
>> to deliver the head. I kept thinking of the "hands off the breech"
>> discussion, God bless Maggie Myles!
>>
>> Every now and then we actually get to do our job in a way that uses
>> knowledge and wisdom passed down from generations before us. Thanks to
>> all of our generation who contribute to my education through ob-gyn-l!
>>
>> --
>> Jane Helwig, MD, FACOG
>> Private practice, 3 MDs, 1 CNM
>> Franktown, VA
>>
>





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Last Updated: Tue Dec 2 04:49:51 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.