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Re: Forces upon forceps application From: R. Daniel Braun (rd.braun@gmail.com) Sun Nov 23 06:44:33 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Bernard Cristalli: "Re: Forces upon forceps application" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Forces upon forceps application" In reply to: Garry E. Siegel, M.D.: "Re: Forces upon forceps application" Next in thread: Garry E. Siegel, M.D.: "Re: Forces upon forceps application" Reply: Garry E. Siegel, M.D.: "Re: Forces upon forceps application" Reply: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Forces upon forceps application" >From ACOG Practice Bulletin 17 2000 Reaffirmed 2008 - *Is there a role for the use of alternative instruments after a failed attempt?* Persistent efforts to obtain a vaginal delivery using different instruments may increase the potential for maternal and fetal injury and often indicates cephalopelvic disproportion. Although studies are limited, the weight of available evidence appears to be against attempting multiple efforts at operative vaginal delivery with different instruments, unless there is a compelling and justifiable reason (28). The California study reported that the incidence of intracranial hemorrhage was highest in infants delivered by combined vacuum and forceps compared with other reported methods of delivery (21). The incidences of other injuries also were increased with combined methods of operative vaginal delivery. Dan On Sat, Nov 22, 2008 at 6:05 PM, Garry E. Siegel, M.D. < garrys@mindspring.com> wrote: > El: > > You're right, and I was very cautious and thought about the situation > before proceeding. > > She was ROA +3 and I felt it would deliver vaginally. I was quite > surprised when I did not achieve any station with the first vacuum pull. > I then switched and it was relatively easy. Perhaps my vector was wrong > on the vacuum, or my application not as good as it should have been. > > Garry > > At Sat, 22 Nov 2008, Dr Eberhard W Lisse wrote: > > > >Forceps after failed Vacuum (for a high head)? > > > >Dr Cochrane will not be helping... > > > >el > > > >On 22 Nov 2008, at 18:58 , Garry E. Siegel, M.D. wrote: > > > >> Dr. Simpson and Luikhart (combined effort) helped me yesterday AM > >> after > >> a vacuum didn't achieve any station with a pull. > >> > >> My instinct was to start with the forceps but the patient put a bit of > >> pressure on me to try the Omni Cup first. > >> > >> As one of my mentors said, if he had to practice Ob on a desert island > >> with only one set of forceps, it would be a set of Kiellands! > >> > >> Garry > >> > >> At Fri, 21 Nov 2008, Andrew Folley wrote: > >>> > >>> Welcome to the "dying art of forceps delivery". Residents today > >>> bluntly state they will never use forceps on a woman. > >>> In one more generation forceps will be relegated to the > >>> hospital museum in the basement. Personally I can not > >>> imagine practicing OB without having comfort in forceps use > >>> and vagian breech delivery. andy > > -- > Garry E. Siegel, M.D. > Private Practice > Roswell, GA > -- R. Daniel Braun, MD FACOG(L) ABMP CMTh 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 Next message: Bernard Cristalli: "Re: Forces upon forceps application" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Forces upon forceps application" In reply to: Garry E. Siegel, M.D.: "Re: Forces upon forceps application" Next in thread: Garry E. Siegel, M.D.: "Re: Forces upon forceps application" Reply: Garry E. Siegel, M.D.: "Re: Forces upon forceps application" Reply: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Forces upon forceps application"

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