Re: Sometimes breeches are just meant to be born vaginally.
From: Dr Eberhard W Lisse (el@lisse.na)
Fri May 30 10:38:12 2008
Bernard,
can you please contact me off list, I'll be on a workshop in Paris
from 2008-06-22 to 27, so we gotta meet :-)-O
el
On May 30, 2008, at 12:23, Bernard Cristalli wrote:
> Safe obstetrics, for women and for kids as well as for doctors is to
> forbid pregnancy.
> That's the only way to avoid pregnancy and delivery complications.
>
> But if you carry on delivering babies, there's no evidence so far a
> CS is better for the kid than a VD.
> Vaginal breeches have thousand years of experience and C-sections
> only a few decades. Complications are on their way. Just have to wait.
> A useless operation is always more dangerous than nothing.
>
> Being used to perform C-section for every breech you see is a point,
> but saying it's the only way to do is untrue.
> Bernard
>
> Dr Eberhard Lisse a écrit :
>> I totally disagree.
>>
>> The golden rule is evidence doesn't lie.
>>
>> And, in Canada for example there just is not difference between
>> vaginal and cesarean deliver wrt maternal mortality.
>>
>> I would also catch a breech if she pushes, but this particular
>> situation is not an example of how to practice safe obstetrics.
>>
>> I have never had issues with dealing with umbilical cords at cesarean
>> breech which I could not resolve immediately. But you can't do that
>> in vaginal delivery, and in prematures the head is more likely
>> to trap the cord.
>>
>> el
>>
>> on 5/30/08 8:30 AM Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.
>> said the following:
>>> At Fri, 30 May 2008, Dr Eberhard W Lisse wrote:
>>>> If we could only know in advance...
>>>>
>>>> If the core had been compromised we would not be so sure any more
>>>> whether the C/S had been necessary...
>>>>
>>>> el
>>>>
>>> And if Mom died from an aspiration,spesis,pulmonary
>>> embolus,bleedind...
>>> we would not be sure whether we did a section for an easy Vag breach
>>> delievery. I.E. try and remove as much risk to the baby as
>>> possible
>>> and in the process lose Mom. The Golden rule is and always will
>>> be Mom
>>> comes first. Moreover you can make a strong arguement that for a
>>> 34 wk
>>> frank breach this late in the second stage a c-section may be just
>>> as
>>> traumatic to baby if not more so than a vaginal delievery.
>>>
>>> --
>>> Take care, John
>>>
>>
>
