all of this disgusts me....
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all of this disgusts me....
Am J Perinatol. 1998 Jul;15(7):443-4. Related Articles, Links
Lower thoracic spinal cord injury--a severe complication of shoulder dystocia.
Hankins GD.
Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston 77555-0587, USA.
Fundal pressure as a maneuver for the relief of shoulder dystocia is associated with up to a 77% fetal injury rate. The usual injuries involve the brachial plexus or orthopedic injuries. We now report a severe lower thoracic spinal cord injury with permanent neurological injury when fundal pressure was applied in an attempt to relieve shoulder dystocia. Shoulder dystocia occurred in a 28-year-old nulliparous woman. A series of manual maneuvers to include episiotomy extension, McRoberts, suprapubic pressure, Woods screw, and extraction of the posterior arm all failed to achieve delivery. During these maneuvers, but not coordinated with them, fundal pressure was applied by multiple individuals. The Zavanelli maneuver and cesarean delivery ultimately allowed delivery. On Day 2 of life marked decrease in lower extremity motor function, over-flow urinary incontinence, and rectal incontinence led to imaging studies that revealed focal spinal cord injury at T-9 through T-12. Compressive forces applied to the fetal spine during fundal pressure is the likely cause of the lower thoracic spinal cord injury manifest by this newborn.
Lower thoracic spinal cord injury--a severe complication of shoulder dystocia.
Hankins GD.
Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston 77555-0587, USA.
Fundal pressure as a maneuver for the relief of shoulder dystocia is associated with up to a 77% fetal injury rate. The usual injuries involve the brachial plexus or orthopedic injuries. We now report a severe lower thoracic spinal cord injury with permanent neurological injury when fundal pressure was applied in an attempt to relieve shoulder dystocia. Shoulder dystocia occurred in a 28-year-old nulliparous woman. A series of manual maneuvers to include episiotomy extension, McRoberts, suprapubic pressure, Woods screw, and extraction of the posterior arm all failed to achieve delivery. During these maneuvers, but not coordinated with them, fundal pressure was applied by multiple individuals. The Zavanelli maneuver and cesarean delivery ultimately allowed delivery. On Day 2 of life marked decrease in lower extremity motor function, over-flow urinary incontinence, and rectal incontinence led to imaging studies that revealed focal spinal cord injury at T-9 through T-12. Compressive forces applied to the fetal spine during fundal pressure is the likely cause of the lower thoracic spinal cord injury manifest by this newborn.
Re: all of this disgusts me....
This is so scary! All those maneuvers were used for the delivery of my son (except for the Zavanelli..He came out vaginally) plus vacuum! It is a miracle that nothing happened to him! He is my first born...he's 12 now. Because he eventually came out OK, the doctor never documented a shoulder dystocia had occured. My second child, daughter, was born with a brachial plexus injury! I could have had 2 children with injuries!
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Re: all of this disgusts me....
Breaks my heart.....
Jazzie,
Wow. Thanks for sharing. It is so frustrating to hear how many people had previous shoulder dystocia and it wasn't documented or it wasn't even documented when the child was injured and it involved a clear shoulder dystocia. Hmmmmmm....and to think of all the bogus articles out there saying, see look at all these injuries with no shoulder dystocia in the medical records, therefore bpi's must happen in utero. What a joke!
Jazzie,
Wow. Thanks for sharing. It is so frustrating to hear how many people had previous shoulder dystocia and it wasn't documented or it wasn't even documented when the child was injured and it involved a clear shoulder dystocia. Hmmmmmm....and to think of all the bogus articles out there saying, see look at all these injuries with no shoulder dystocia in the medical records, therefore bpi's must happen in utero. What a joke!
Re: all of this disgusts me....
I think the manuevers mentioned (mcroberts, corkscrew, etc) are all pretty damn useless then people are jumping up and down on the stomach forcing the shoulder harder and harder into the pubic bone. Why even BOTHER trying them???
Disgusted and horrified
Kate
Disgusted and horrified
Kate
