-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: to push or not to push From: Meenan, Anna (annam@uic.edu) Tue Jul 28 19:23:50 2009 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Rafael Haciski: "Re: Surgical Prophylaxis Done Right" Previous message: Ina May Gaskin: "Re: to push or not to push" In reply to: Ina May Gaskin: "Re: to push or not to push" Next in thread: Dr Eberhard Lisse: "Re: to push or not to push" Agree with Ina May. I try McRoberts first and have them give one good push. If the anterior shoulder doesn't come, I have the mom roll over to all-4's and deliver the posterior shoulder. I tend to cup my hand over the shoulder, gently grasp the humerus with my fingers, and pull in the long axis of the humerus while lifting upwards on the sacrum, which is quite mobile in most women at term. Anna Meenan, MD, FAAFP >I've only worked with women who were able to move and support their >own weight. Step 1: get the mother to turn to hands and knees. Most >will then have the urge to push. If not, I'll splint my first two >fingers across the posterior armpit (it's usually the easier to get) >and deliver the shoulder. If that's not possible, it may be possible >to grasp one of the hands and deliver whichever shoulder it's >attached to. The rest should be easy. > >Another variation is to have the mother take a "step" forward with >first one knee, then the other to free an impacted shoulder. > >Ina May > >On 28 Jul 2009, at 17:03, Christopher Jones wrote: > >>When you encounter a shoulder dystocia do you have you patients continue >>to push during your efforts to deliver the anterior shoulder? Ive heard >>different views regarding this. Essentially the non push proponents >>believe pushing just further impacts the anterior shoulder behind the >>pubic symphysis. Personally I have my patients push during McRoberts >>and Suprapubic pressure but if I have to go to one of the rotations or >>posterior arm pushing just hinders the efforts. >> >>Wanted to get opinions. >> >>Thanks >> >>Dr. Christopher Jones Next message: Rafael Haciski: "Re: Surgical Prophylaxis Done Right" Previous message: Ina May Gaskin: "Re: to push or not to push" In reply to: Ina May Gaskin: "Re: to push or not to push" Next in thread: Dr Eberhard Lisse: "Re: to push or not to push"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Dec 2 05:14:35 2009

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.