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Re: OB shoulder dystociaFrom: Joanne Bulley (jbulley@cheshire.net)Tue Feb 3 21:19:22 1998
>Wed, 28 Jan 1998 >Friend of mine wrote up her experience of having a total shoulder >dystocia, where she just couldn't deliver and the babe died. "Personal >View" in the BMJ ~ 1994. >Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt I, too, have had a total dystocia with the death of the babe. 1987. Between the end of making my case list and sitting fo the orals. When they came to a shoulder dystocia question on the orals (by way of a kodachrome of a recto-vaginal fistula), I went through the litany of that day andrelived the whole agonizing series of maneuvers and those agonizing minutes. When my examiner said "the baby is out with good APGAR's ..." (then went on to assess and repair the perineum and vagina) I almost said "Thank God" about the live birth. I will remember that delivery in great detail forever. The baby was 12#12 oz, mom's second baby. (There was a suit and it was finally settled) My second worst one was with a 6#12 oz baby. My largest live born, no problems with delivery was 13# something. Then there is the woman I delivered whose first weighed only 7#6 oz and seemed to just barely squeeze through. I was there for the next delivery. I was quite certain the second was larger by a good amount, and was agonizing about it. I barely got my gloves on in time to literally catch it - weighing 11# 4 oz!!!! As any of us who have been delivering a while - shoulder dystocia is NOT predicatable. A lot of C/S need to be done to prevent a single shoulder dystocia - creating more risk than is being solved. Anyone have any bright ideas on how to reduce the legal cases when this is really a known risk that cannot truly be predicted??? Work: Home: Joanne E Bulley, MD, FACOG Joanne E Bulley Hitchcock Clinic - Keene jbulley@cheshire.net Joanne.E.Bulley@Hitchcock.ORG
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