Re: Rhogam
From: westsidebirthservice@juno.com ("westsidebirthservice@juno.com")
Fri Feb 27 07:00:18 2009
Glen,
You also need to be cautious of what I kindly call "sea biscuits." There is a net designed for this :) Many who do water birth either have the woman labor in the tub and come out for the birth and placenta or labor out of the tub and go in only for the birth and then out again for the placenta. Can't estimate EBL in the water for sure. I think the fad will fade out soon.
Louana
-- Glen Elrod <dr99645@yahoo.com> 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
Glen,
You also need to be cautious of what I kindly call "sea biscuits." There is a net designed for this :) Many who do water birth either have the woman labor in the tub and come out for the birth and placenta or labor out of the tub and go in only for the birth and then out again for the placenta. Can't estimate EBL in the water for sure. I think the fad will fade out soon.
Louana
-- Glen Elrod <dr99645@yahoo.com> 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
