Re: 100 lbs wieght gain, o.p. multip
From: R. Daniel Braun (rd.braun@gmail.com)
Sat Oct 20 10:08:49 2007
Don't get in that situation. If you do, you should have sectioned her
earlier.
I have been there and done that. That is why I say "Don't go there to start
with".
IMHO
Dan
On 10/20/07, RModugno@aol.com <RModugno@aol.com> wrote:
>
> In a message dated 10/20/2007 10:42:27 A.M. Eastern Daylight Time,
> elishyde@mindspring.com writes:
>
> On Oct 20, 2007, at 10:14 AM, Richard Kaplan wrote:
>
> > Having a size 6 hand, I have had pretty good luck with manual
> > rotation from OP (I haven't used Kiellands since I was a
> > resident). Does anyone who has done this often have any "pearls"
> > on how to determine which way to rotate the head (clockwise or
> > counterclockwise) other than to try one way and then the other if
> > the first attempt fails (e.g. ultrasound or abdominal palpation to
> > determine the relationship of the shoulders to the vertex)?
>
> I always try the 'short arc' rotation. In addition, I've been most
> successful doing this with an assistant. While I rotate the head,
> the assistant is rotating the body in the same direction. I find that
> more successful than just rotating the vertex.
>
> Betsy Hyde CNM
> Branford, CT
>
> Great advice Betsy!
>
> If I do a section on this type of patient - I usually have an assistant
> push up from below to try to avoid those horrendous extensions of the lower
> uterine segment. Anyone have any pearls for that?
>
> Had a patient not too long ago where I had someone push up from below and
> I "lost" the head. Baby started to go up the left paracolic gutter, couldn't
> retrieve the head and so had to do a breech extraction to deliver the baby!
> (Ofcourse it was one am.)
>
> Robert Modugno MD MBA FACOG
> Sylva, NC
>
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--
R. Daniel Braun, MD FACOG(L) CMT
Professor Emeritus
Dept. of Obstetrics and Gynecology
Indiana U. School of Medicine
R. Daniel Braun
"Science without Religion is LAME; Religion without Science is BLIND"
Einstein 1941
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