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Re: episiotomy and shoulder dystocia wasits effects on From: Aaron M Mendel (amendel@juno.com) Fri Apr 25 18:15:12 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: dahmd@gate.net: "Offering patients alternative Pap methods" Previous message: Paul Prior MD: "Re: shoulder dystocia" On Fri, 25 Apr 1997 06:44:48 -0500 rbraun@indyunix.iupui.edu writes: >How many of you feel that episiotomy is actually of any benefit in the >management of shoulder dystocia ? How many feel that it is not of any >benefit? I know all the text books say that a LARGE episiotomy is a >must, >but I still am not sure how that helps. >Come on everybody out there answer this one. >Let's make it a real poll. > >--I agree, the point of impaction is not at the perineum. the only benefit of a large episiotomy is to allow you to reach in in order to sweep the arm and deliver the posterior shoulder. I've always felt that if I had SO much room in the pelvis that I could do this then why is there a dystocia at all. Good topic. Aaron Aaron Mendel MD Fallon Clinic Director Ob/Gyn Educ. St. Vincent Hospital Worcester MA >@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ >R. Daniel Braun, MD FACOG "Money will buy you a fine >dog >Clinical Professor OB/GYN but only love will make it >Indiana University School of Medicine wag its tail" >Indianapolis, IN Richard "Kinky" >OBGYN.net, International Rep. U.S. Friedman > Kinky Friedman for President >@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ > >On Thu, 24 Apr 1997, Robert J Woolley wrote: > >> >> On Thu, 24 Apr 1997 DoctorJoe@aol.com wrote: >> >> > I just found out that some people DO still do mediolaterals. The >residents at >> > a program I just visited (I won't say WHERE) told me that their >UROGYNs tell >> > them to do mediolaterals, to avoid the rectum. (And you can't say >these are >> > uncaring male chauvinists who don't feel the patients' pain - my >> > understanding was that the urogyns in this place were women). >> >> It trades one set of problems for another. I don't think there is >any >> clear answer which set of problems is better. Personally, I think >it's >> about a wash. >> >> But of course, I think the more interesting question is whether >*any* >> patient should receive *any* episiotomy. And I'm darn close to >saying >> "no", though I still grant a few reasonable exceptions (probably, >though, >> totaling only about 1% of deliveries). >> > Next message: dahmd@gate.net: "Offering patients alternative Pap methods" Previous message: Paul Prior MD: "Re: shoulder dystocia"

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