Re: Rhogam
From: art fougner, md (evsono@pipeline.com)
Thu Feb 26 19:26:16 2009
The RCOG referenced this article -
One review identified 16 articles reporting a total of 63 neonatal
complications attributable to water birth, including drowning,
respiratory problems, cord avulsion and waterborne infections.
Anderson T. Umbilical cords and underwater birth. Practising Midwife
2000; 3(2):12.
Glenn ... it's great the "refuseniks" have someone to turn to when the
fit hits the shan. Just make sure it's not your fit when it happens.
Art
At Thu, 26 Feb 2009, Glen Elrod wrote:
>
>I thought about a snorkel. I wished I had the extra long gloves. I was a bit concerned about going out to dinner last night that I might not have scrubbed enough after the delivery.
>
>Its incredibly odd not being able to see what you are doing when the head crowns, being disoriented when you try to figure out which way is down for the anterior shoulder, but no tears, EBL of 100 at most and a great baby.
>
>BTW, if the goal is to get out of the tub to deliver the placenta, I would caution against doing anything to the cord clamp. It looked like a massacre in the tub when I just moved the clamp a bit.
>
>Glen
>
>________________________________
>From: Richard Chudacoff <rchudacoff@mylinuxisp.com>
>________________________________
>
>--
>________________________________
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>
>________________________________
>Sent: Thursday, February 26, 2009 3:53:47 PM
>Subject: Re: Rhogam
>
>With or without mask, fins and snorkel?
>
>Richard Chudacoff, MD, FACOG
>
>From:ob-gyn-l@obgyn.net
>[mailto:ob-gyn-l@obgyn.net] On Behalf Of Glen Elrod
>Sent: Thursday, February 26, 2009 4:31 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Rhogam
>
>AFI of 37, bilateral hydronephrosis with right
>ureteral obstruction.
>
>The local midwives really didn't feel comfortable doing this delivery.
>Their regs say they need to consult with an MD for poly. I brought her in
>for amniotomy with needle.
>
>I've been (ready for flames) been thinking about water birth for a while, since
>I've been watching a whole host of midwifery 'propaganda' movies
>recently. We have a birth tub but no policy. She got in the tub for
>labor and with the CDM help we had a water birth. That situation totally
>flies in the face of AWHONN standards and protocols.
>
>Glen
>
>________________________________
>
>________________________________
>From:Richard Chudacoff<rchudacoff@mylinuxisp.com>
>________________________________
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>
>________________________________
>Sent: Thursday, February 26, 2009 2:54:27 PM
>Subject: Re: Rhogam
>Home delivery? Why did she come to
>see you at all?
>
>Richard Chudacoff, MD, FACOG
>
>From:ob-gyn-l@obgyn.net
>[mailto:ob-gyn-l@obgyn.net] On Behalf Of Glen Elrod
>Sent: Thursday, February 26, 2009 3:36 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Rhogam
>
>Transfusion was the only thing I could
>come up with. but the liklihood is so low.
>
>Why the objection? Probably the same reason she objected to fetal
>monitoring, pit, vit K, eye ointment, etc etc etc.
>
>Glen
>
>________________________________
>
>________________________________
>From:"art fougner, md"
>________________________________
><evsono@pipeline.com>
>________________________________
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>
>Sent: Thursday, February 26, 2009 1:59:12 PM
>Subject: Re: Rhogam
>
>Oh transfusion reaction down the road, difficulties if a transplant
>needed ... what exactly is her objection?
>
>Art
>
>At Thu, 26 Feb 2009, Glen Elrod wrote:
>>
>>Pt today is s/p delivery and is refusing Rhogam. Baby was Rh +, but
>they are certain they are done having kids. He is having a
>vasectomy. She states she will not have other children even if her
>children die, husband dies, etc.
>>
>>Is there any NON-pregnancy risk to not getting Rhogam now?
>>
>>Glen
>
>--
>art fougner, md
>"May The Wings of Liberty Never Lose a Feather." - Jack Burton
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
