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Re: 2nd stage durational dilemmas From: Antonio Valdez (avaldez@infolnk.net) Tue Dec 29 13:41:02 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Thomas Ind: "Re: Oysters" Previous message: Marjorie Dacko, CM: "Re: Vulvar hematoma" In reply to: Karen D. Kudia: "new thread : 2nd stage durational dilemmas" At 10:12 PM 28/12/98 -0600, you wrote: >What is optimal management of prolonged second stage of labor? What is the >influence of the >duration of second stage on perinatal outcome and puerperal morbidity? >Karen >(Ocala Fl CNM) Karen, you have a great question... As I know; the duration of the second stage, if you have a carefully survillence of the fetal well being (fetal monitoring, pH sampling) doesn'y influence the perinatal outcome; so, the arbitrary concept that more than 2-hours of second stage is dystocia is not true; it can be of 3,4 hours with no influence on the perinatal outcome; BUT, who can be OK waitnig so long.... And the other hand, the more time the second stage is, more is the neural damage (pudendal) the the fetal head produce to tne maternal pelvis; so we can wait more pelvic problems in the futere...I don't have the reference (I will look for it) but there is a paper the suggest the liberal use of forceps to reduce the second stage and reduce future pelvic probles.... So... I,m a forcep's fan...so I don't wait more that an hour of second stage to use a kjelland (critice me, but I have to be honest) BTW; anybody in the list use the Mueller-Hillies Manouver to predict second stage problems...I always use it..I think it's good... Happy New Year to all of you... -- Antonio Valdez-Torres MD FACOG Hospital Guernika Ciudad Juarez, Chihuahua, MEXICO Next message: Thomas Ind: "Re: Oysters" Previous message: Marjorie Dacko, CM: "Re: Vulvar hematoma" In reply to: Karen D. Kudia: "new thread : 2nd stage durational dilemmas"

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