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Re: What would you doFrom: Atkinson, Samuel M (ATKINSONS@ECU.EDU)Mon Aug 28 08:39:57 2006
I would call for the Pipers, cut a large episiotomy and yell push! But then again, I have delivered breeches before the days of safe cesareans and malpractice lawyers. I also would have known earlier it was breech and so would my nurses with the portable US every L&D must have this day and time. So I wouldn't have done the AROM. Without a good baby the AROM becomes the real critical event. Sam Atkinson -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Sunday, August 27, 2006 10:16 PM To: Multiple recipients of list OB-GYN-L Subject: OB: What would you do 33 YO P0 at 32w4d presents in PTL at 7 cm/Bulging BOW. On my exam, AROM--9 cm., vertex--just got epidural. Called to delivery from sleep--+3 station, and after a couple of minutes and very good pushes, she's +4, and, by the way, frank breech. Her epidural is such that between pushes the presenting part recedes inside the introitus. I do think that there is time to do a section, if desired. Your thoughts. . . Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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