Re: footling breech

From: Joanne Bulley (jbulley@cheshire.net)
Sat Nov 29 15:38:38 1997


I agree with Dr. Robertson:

>There have been times when the lady had a good pelvis,
>was a multip, and I new the baby was not large that I was sorely tempted to
>give it a try, but it would be considered malpractice here.
>
>Definition - Feet are BELOW the buttocks. (Feet and bum together is a
>complete breech not a footling)
>
>Precautions - don't have an epidural service therefore cannot offer one. I
>would like the option and would probably use it. All breech deliveries are
>done in our "High Risk" room (we do all C/S on the Mat floor and this is
>also our High Risk room). Anaesthesia is made aware of Breech delivery,
>and if Anaesthesia is not in house strong consideration is given to calling
>them in on standby. IV started, paediatrics ready, pipers ready.

I do my own epidurals, but when delivering breeches (don't do footling's on purpose for the same reasons others have cited.) I would have anesthesia there, he would do the spinal (or epidural) and I would have the OR team in house.

>
>Literature - There was a recent concensus conference on breeches by the
>SOGC. I will try to find it and look at the references for you. This
>spawned the Term breech trial being run out of Toronto, but footling is an
>exclusion criteria.
>
>J.G.M.Robertson MD, 109-9181 Main St. Chilliwack, B.C. 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)
>

--

Joanne Bulley, MD Keene, NH





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