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Re: +3/5From: Jane Helwig, MD (jane@seasonedsystems.com)Sat Jun 27 18:30:45 1998
Robert or Peter or Malcolm, Can you please give more details about abdominal assessment of engagement? What exactly did Professor Philpott tell the midwives to do in their exam? I find the statement that engagement doesn't occur in African patients until labor very interesting. Patients here are >50% African-American. Some c/s here are done because the presenting part is "high" and progress has been unsatisfactory, with indication for c/s "CPD". Often these babies are small, <3000g. While I know from recent experience that even a little baby can be a struggle to deliver vaginally, abdominal assessment of progress might be a useful adjunct. Does engagement not occur in African patients (and perhaps in some African-American patients) before labor because of pelvis shape--molding produced by labor is necessary for engagement? Please tell us more. Jane
-- Jane Helwig, MD Private practice Nassawadox, VA
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