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Re: Difficult twins From: Garry E. Siegel, M.D. (garrys@mindspring.com) Sat Dec 30 18:50:02 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Larry Glazerman: "Re: ABOG Board Recertification Time" Previous message: Garry E. Siegel, M.D.: "Re: ABOG Board Recertification Time" In reply to: Larry Glazerman: "Re: Difficult twins" Next in thread: Ina May Gaskin: "Re: Difficult twins" Difficult is an understatement. One would think that you could do an internal podalic version since she just delivered vaginally. One also would not to find out if one was wrong, either. I hope that you were in an OR, with an epidural in place, an anesthesiologist in the room, and a C/S table in the room, too. That is how I deliver twins. I think that I would have to have a good sense that the second could come through easily via internal podalic version or I would section. Garry At Sat, 30 Dec 2006, Larry Glazerman wrote: > >Would you do a podalic version at 6 cm? I'd really worry about head >entrapment. > >On Dec 30, 2006, at 7:44 PM, DoctorJoe@aol.com wrote: > >> In a message dated 12/30/06 6:26:31 PM, agfolley@hotmail.com writes: >> >>> what do you do??? >>> On call last night. Induced twins for my partner. G2P1 38 weeks. >>> Vertex/vertex di/di. Patient with epidural. First baby comes out >>> 6:00 pm >>> vacuum outlet assist. no problems. Next baby vertex at -2 cx 5-6 >>> cm. Of >>> course nurse says heart tones are down in 50-60s. Time 6:05. US >>> shows >>> heart rate is low. Mom pushes baby not coming out. AROM second >>> twins bag >>> clear fluid. Could not apply vacuum due to membranes, placenta >>> from first >>> baby in way etc. 6:08 pm heart tones still down. Nurse says can >>> not find >>> heart rate. Mom looks at dad, dad looks at me, I look to see if my >>> lawyer >>> has showed up yet. What do you do????????????????? >> >> C/S immediately or internal podalic version and extraction are the >> only things that come to mind. >> >> Joe P. >> >-- >Larry R. Glazerman, MD, FACOG >St. Luke's Center for Advanced Gynecologic Care >250 Cetronia Road >Suite 305 >Allentown PA 18104 >484-223-3279 >484-223-2830 FAX >glazerl@slhn.org > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Larry Glazerman: "Re: ABOG Board Recertification Time" Previous message: Garry E. Siegel, M.D.: "Re: ABOG Board Recertification Time" In reply to: Larry Glazerman: "Re: Difficult twins" Next in thread: Ina May Gaskin: "Re: Difficult twins"

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