Re: Episiotomy question
From: allanho@aol.com
Tue Feb 19 13:12:10 2008
Efrain, may be you were mistaken!? Maybe my message was not so clear.? In any case your "humble opinion" did not?come acrosss as?so humble.??I wish?you?would Refrain from making personal judgement when part taking in an academic discussion.?
Allan
-----Original Message-----
From: Efrain Ramirez <eramirezt@coqui.net>
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>
Sent: Tue, 19 Feb 2008 8:03 am
Subject: Re: Episiotomy question
Allan - you can call me Dude, sir- whatever ...listers know who I am...
maybe I am mistaken --- "With the McRobert Maneuver, the sacrum should
be off the bed, so it should have the same effect as being up-side-down
in the air.? I don't understand the part with gravity being in your
favor unless the patient is squatting.? And if its the expulsive force
that's critical, why is fundal pressure such a taboo?"
>
>Allan
At Mon, 18 Feb 2008, AllanHo@aol.com wrote:
>
>In a message dated 2/18/2008 9:01:57 PM Eastern Standard Time,
>eramirezt@coqui.net writes:
>
>Allan the mechanisms of shoulder dystocia - IMHO - are not so clear in
>your mind.. the expulsive forces are not the critical factor in SD -
>the impingement of the shoulder behind the symphis - or the sacrum in
>the cases of the posterior shoulder is the problem.. if you give fundal
>pressure to an already stucked shoulder you will further increase damage
>- if you release the shoulder - by whatever maneuver you wish - then the
>expulsive forces will do the rest.. take care..
>
>Ef
>
>Dude (I mean sir), I am not proposing fundal pressure to deliver a stuck
>shoulder! I was asking Ina May why she thought gravity would help deliver a
>stuck baby when we know the expulsive force is not a factor. I am contending
>that it is the movements that unstick the shoulder, given that the outlet
>dimensions are the same when a woman is in the McRobert position and the
>on-all-4's position. Please read what I wrote carefully before you condemn
what is in
>my mind. Thanks.
>
>Allan
--
"I can accept failure, but I can't accept not trying." - Michael Jordan
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Efrain, may be you were mistaken! Maybe my message was not so clear. In any case your "humble opinion" did not come acrosss as so humble. I wish you would Refrain from making personal judgement when part taking in an academic discussion. <br>
<br>
Allan<br>
<br>
-----Original Message-----<br>
From: Efrain Ramirez <eramirezt@coqui.net><br>
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net><br>
Sent: Tue, 19 Feb 2008 8:03 am<br>
Subject: Re: Episiotomy question<br>
<br>
<div id=AOLMsgPart_0_e12b955f-5c03-453f-933b-fdefd76d8fbd style="FONT-SIZE: 12px; MARGIN: 0px; COLOR: #000; FONT-FAMILY: Tahoma, Verdana, Arial, Sans-Serif; BACKGROUND-COLOR: #fff"><PRE style="FONT-SIZE: 9pt"><TT>Allan - you can call me Dude, sir- whatever ...listers know who I am...
maybe I am mistaken --- "With the McRobert Maneuver, the sacrum should
be off the bed, so it should have the same effect as being up-side-down
in the air.? I don't understand the part with gravity being in your
favor unless the patient is squatting.? And if its the expulsive force
that's critical, why is fundal pressure such a taboo?"
>
>Allan
At Mon, 18 Feb 2008, <A href="mailto:AllanHo@aol.com">AllanHo@aol.com</A> wrote:
>
>In a message dated 2/18/2008 9:01:57 PM Eastern Standard Time,
><A href="mailto:eramirezt@coqui.net">eramirezt@coqui.net</A> writes:
>
>Allan the mechanisms of shoulder dystocia - IMHO - are not so clear in
>your mind.. the expulsive forces are not the critical factor in SD -
>the impingement of the shoulder behind the symphis - or the sacrum in
>the cases of the posterior shoulder is the problem.. if you give fundal
>pressure to an already stucked shoulder you will further increase damage
>- if you release the shoulder - by whatever maneuver you wish - then the
>expulsive forces will do the rest.. take care..
>
>Ef
>
>Dude (I mean sir), I am not proposing fundal pressure to deliver a stuck
>shoulder! I was asking Ina May why she thought gravity would help deliver a
>stuck baby when we know the expulsive force is not a factor. I am contending
>that it is the movements that unstick the shoulder, given that the outlet
>dimensions are the same when a woman is in the McRobert position and the
>on-all-4's position. Please read what I wrote carefully before you condemn
what is in
>my mind. Thanks.
>
>Allan
--
"I can accept failure, but I can't accept not trying." - Michael Jordan
</TT></PRE></div>
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