Re: Difficult twins
From: Bernard Cristalli (bcrist@club-internet.fr)
Sun Dec 31 06:10:31 2006
Breech extraction.
Quicker than a C-section and mom has already proved she can be delivered
vaginally.
BC
Andrew Folley a écrit :
> favorable cervix, end of year patient request yadda yadda yadda
> As far as csection goes, it may take 15-20 minutes to do. anesthesia
> tied up etc.
> what now?????
>
>> From: Larry Glazerman <l.glazerman@rcn.com>
>> Reply-To: ob-gyn-l@obgyn.net
>> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>> Subject: Re: Difficult twins Date: Sat, 30 Dec 2006 18:39:14 -0600
>>
>> First of all, why induce? Otherwise, I'd section the second twin.
>>
>> On Dec 30, 2006, at 7:26 PM, Andrew Folley wrote:
>>
>>>
>>> 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?????????????????andy
>>>
>>>> From: "Andrew Folley" <agfolley@hotmail.com>
>>>> Reply-To: ob-gyn-l@obgyn.net
>>>> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>>>> Subject: Re: Sheehan's syndrome
>>>> Date: Sat, 30 Dec 2006 10:33:11 -0600
>>>>
>>>> Furthermore, it would be unlikely that she would be able to breast
>>>> feed if there were true pituitary necrosis. agf
>>>>
>>>>> From: DoctorJoe@aol.com
>>>>> Reply-To: ob-gyn-l@obgyn.net
>>>>> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>>>>> Subject: Re: Sheehan's syndrome
>>>>> Date: Sat, 30 Dec 2006 07:49:01 -0600
>>>>>
>>>>> In a message dated 12/29/06 5:59:49 PM, ljmidwife@aim.com writes:
>>>>>
>>>>> > I know that Sheehan's is rare (1:10,000) but also know symptoms
>>>>> can show up
>>>>> > weeks to years after the occurrence.
>>>>> > None of my research talked about the extent of blood loss that
>>>>> can result
>>>>> > in Sheehan's. Does anyone on the list have experience with this
>>>>> and can fill
>>>>> > me in?
>>>>> >
>>>>>
>>>>> Sheehans occurs when there is such dramatic blood loss that the
>>>>> patient
>>>>> "shocks out" and the pituitary necroses for lack of blood supply.
>>>>> In your patient's
>>>>> case, with only 2 units of blood and a Hgb of 6+, I doubt that she's
>>>>> affected.
>>>>>
>>>>> Joe P.
>>>>>
>>>>
>>>
>>> href=http://davevscarl.spaces.live.com/?icid=T001MSN38C07001
>
>> Globes has
> it all. http://tv.msn.com/tv/globes2007/
>
