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Re: breech in nulipara From: William Graves, M.D. (wgraves@obg.med.uth.tmc.edu) Mon Dec 9 09:32:46 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DOCJOE2855@aol.com: "abgs on cord?" Previous message: lqqiu@pub.zjpta.net.cn: "ask how to get maillist" Maybe in reply to: RAUL DORBECKER: "breech in nulipara" Next in thread: bclaure: "Re: breech in nulipara" Bernard Cristellie wrote: I do think breech is one of (the) elective indications for epidural (likemultiple pregnancies history of c/s). I'm afraid that I agree with Dr. Griffith's insofar as the influence of epidural in nulliparous women undertaking a vaginal delivery for breech. I would cite the largest study of breech deliveries (1,456 term breech presentations) in the English literature. 274 were nullparas: 175 received epidural and 98 did not. Cesarean section rates were 53% and 20% respectively. These were "strong" Scottish women, admittedly, but what is your vaginal delivery rate in comparing epidural and non-epidural management? Chadha et al Br. J Obstet Gynaecol 1992:99:96. >Malcolm Griffiths wrote: >> > >> >How do you manage a nullipara with a breech presentation at term? >> > I fthey do I always advise them to avoid epidural, >> unless they want it for pain-relief. I believe it is not indicated >> electively for breeches ( reasons on request ). >> > >I quite disagree with that opinion. I do think breech is one of >elective indications for epidural (like multiple pregnancies and >history of CS). All these situations can lead to "do something". It's >rather more comfortable to perform an extraction or a CS quietly under >epidural than to be stressed by an emergency general anesthesia. > >Epidural and, of course, pitocin! > >Bernard Cristalli MD CNGOF >Paris - France > Next message: DOCJOE2855@aol.com: "abgs on cord?" Previous message: lqqiu@pub.zjpta.net.cn: "ask how to get maillist" Maybe in reply to: RAUL DORBECKER: "breech in nulipara" Next in thread: bclaure: "Re: breech in nulipara"

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