Re: Obstetrical paracervical block

From: rbraun@iupui.edu
Sat Nov 22 06:50:38 1997


Malcolm and Bernard's responses are interesting. They did not live throught the time period when this was occurring and it is interesting to see their fear and thei gestalt on this procedure. As I said in my earlier response, the studies that were done have shown that the problem was a dose related one. It also was a prolonged deceleration not fetal distress or even a bradycardia. Bradycardia is defined as a BASELINE FHR of less than 110 BPM. See Hon, EH any of his books will do. Also in case somebody doesn't know, the Baseline FHR is defined as : The average FHR over 10 minutes, exclusive of accelerations and decelerations.

R. Daniel Braun, MD FACOG

On Sat, 22 Nov 1997, Malcolm Griffiths wrote:

> In message <199711220602.AAA29611@talk.obgyn.net>, "D.Crowther"
> <crowther@wctc.net> writes
> >I am a family physician practicing obstetrics and I have recently
> >immigrated to the USA from Canada. I am currently being exposed to the
> >use of paracervical blocks during labour, a technique I had not
> >previously utilized. I would appreciate comments on the consensus of
> >opinion in regards to this form of anaesthesia. I thankyou in advance.
> >
> This technique was abandoned in UK some time ago. I can't quote
> references but recall it was associated with fetal bradycardias. I also
> seem to remember that there were reports of inadvertent fetal scalp
> injections and worse!
> Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt
> Obstetrician & Gynaecologist Luton & Dunstable Hosp.,UK.
> Tel: 01582-497459 (office) Fax: 01582-497376
> 01525-222849 (home) email: Malcolm@mgriff22.demon.co.uk
> http://www.obgyn.net/board/griffith.htm
> "CLINICAL FREEDOM IS THE LAST REFUGE OF THE CLINICALLY INCOMPETENT!"
> (Someone [1997])
>





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