|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: 1999 BMJ articel on cord prolapseFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Mon May 22 15:53:26 2006
At Mon, 22 May 2006, Stmidwife@aol.com wrote: > >El, how often is this done and is it still done? > >What to do with prolapsed pulsating umbilical cords 5 May 1999 > >Anne Seymour Send response to journal: >Re: What to do with prolapsed pulsating umbilical cords > > EDITOR-I note from tomorrow's BMJ that patients still present with >prolapsed pulsating cords in places where Caesarean section is not possible >necessitating transfer of the patient. The article recommends the traditional methods >of holding up the presenting part. In West Africa we have found the following >method more successful. Pass a catheter and run in one bottle of intravenous >saline (or if that is too expensive cooled boiled water). Disconnect the giving >set and spigot the catheter. Most patients are very co-operative if they have >been given a careful explanation of the procedure. As well as supporting the >presenting part the full bladder tends to diminish contractions. Above all do >not give up hope! Mama X went to her Traditional Birth Attendant (TBA) at 9pm. >A prolapsed cord was found and acting on her protocol (she had done a six >week course sponsored by Government and Mission) she referred Mama X to the Aid >Post. Here the Nursing Aide (one year nursing course) acted on her instructions >and referred Mama X to the Health Centre, having put a warm wet cloth and a >pair of panties to protect the cord. At the Health Centre the Nurse /Midwife >(three year course) referred her to the hospital. No one suggested the relatives >carry her on a stretcher, so she walked. At 5am next morning she came into >the maternity department by one door as I came in by the other. Leaving the >labour ward nurse to get her ready I went to assemble the theatre staff. At 5.45am >a healthy baby was born. Anne Seymour Retired Mission Doctor Harton House Rd >South Shields 1 Geoffrey Chamberlain, Philip Steer ABC of labour care Unusual >presentations and positions and multiple pregnancy BMJ1999 1 May 1192- 1194 Filling the blader is part of the recomended protocal going back 4 decades or more. The key to a good outcome is the Mom not being in active labour, paradoxically an unengaded head makes a good outcome more likely though it makes a prolapse more likely. The worst outcomes are the ones in active labor with an engaged head when diagnosis is first made, if you think that's not possible you have not taken care of enough Mom's. I get a cord prolapse (not including twins which is very common and handled by propt delievery) about once every 250-300 deliviers; I have not had one in about 350 delieveries so any day now...
--
Take care, John
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 05:03:04 2009 |
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.