Re: 1999 BMJ articel on cord prolapse
From: Bernard Cristalli (bcrist@club-internet.fr)
Mon May 22 18:23:30 2006
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Your gold standard is to be over 16 minutes? Why do you go so slow?
BC
Dr Eberhard Lisse a écrit :
>No idea,
>
>we try to get the baby out in under 17 minutes. Last Thursday we managed
>19 minutes in a fetal bradycardia at 34 weeks and 2 weeks IGUR.
>
>el
>
>on 5/22/06 9:43 PM Stmidwife@aol.com said the following:
>
>>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
>><http://bmj.bmjjournals.com/cgi/eletter-submit/318/7192/1192?title=Re%3A+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
>>
>
