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Re: Episiotomy questionFrom: Ginny Lee (kaupilimakoa@hotmail.com)Sun Feb 17 14:53:09 2008
Anna 2 significant shoulder dystocias for me this year, both resolved with delivery of posterior arm, first one without epis, second one with. Both moms with epidurals---couldn't get them into hands and knees unfortunately, but I agree with the extra room. Lucky to have small hands :) Date: Sun, 17 Feb 2008 14:35:21 -0600From: annam@uic.eduTo: ob-gyn-l@mail.obgyn.netSubject: Re: Episiotomy question Direct fetal manipulation with either rotational maneuvers or delivery of the posterior arm also may be used (43). In these circumstances, performance of a proctoepisiotomy may be helpful to create more room within the posterior vagina." Allan That was undoubtedly written by someone who has only ever tried to get into the posterior vagina while mom was sitting on it and baby was lying on it. Try it when baby being pulled anteriorly by gravity and sacrum levered up posteriorly by attending's hand (and arm), as they are in the all-4's position. As I said, the amount of extra space you achieve is AMAZING. The last time I did it, I was able to reduce a posterior arm that was trapped behind the baby's back. Anna Meenan, MD _________________________________________________________________ Climb to the top of the charts!=A0Play the word scramble challenge with sta= _________________________________________________________________ r power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan
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