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Re: Breech ProtocolFrom: John Robertson (jgmr@unixg.ubc.ca)Thu Dec 21 09:11:12 1995
>I Name of the Protocol >Vaginal Delivery of a Breech Presentation
>II Rationale for having the protocol
>III Prerequisites Would not offer version while in labour, I give ritodren to relax a non labourin uterus before I turn it, I feel I would be tilting at windmills if she were in labour
>b. Frank breech What about ratio of head circumference to abdominal circumference?
>IV Contraindications What about a complete breech?
>V Technique I realize that episiotomy is recommended but I have often found it unneccessary. If I need to do one it only takes 10- seconds, and I do it as needed.
>VI Controversial Areas (Relative contraindications)
Personally I have no problem with these, but I certainly understand the concerns.
>b. Morbid obesity. Only as it relates to foetal macrosomia
>c. Previous Cesarean section. If the scar can tollerate labour with a cephalic position why not with a breech?
>d. Multiple pregnancy.
Will do if there is not a great discrepancy between twins.
>e. Induction of labor.
will do
>f. Augmentation of labor. will do
>VII Documentation needed for retrospective evaluation of the protocol. agree
>This is a starting place.
>Who wants to critique the hell out of this attempt? Specificallty the List needs to address the controversial areas.
>Have a happy holiday one and all.
>Peter
>Peter V. Weston, M.D.
>"More harm is done because you do not look Than from not knowing what is in the book" Zachary Cope I have the Canadian recommendations which were recently published, I will try to find and place on the list. J.G.M.Robertson MD, 109-9181 Main St., Chilliwack, B.C., Canada, V2P 4M9 (604) 793-9988 e-mail jgmr@unixg.ubc.ca The best we can do for one another is to exchange our thoughts freely; and that, after all, is about all. James A. Froude (1818-1894)
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