On Sat, 26 Apr 2008 13:01:21 -0400, "sharon" <nobody@[EMAIL PROTECTED]
>
wrote:
>
>"Paul Bearer" <replyonusenet@[EMAIL PROTECTED]
> wrote in message
>news:8oj614lmbbs29qj7vt6t4s2ign5ukm7rqi@[EMAIL PROTECTED]
>> On Sat, 26 Apr 2008 00:19:02 -0400, "sharon" <nobody@[EMAIL PROTECTED]
>
>> wrote:
>>>Hell, just last year, Abby sawed some chick's pelvis in half to do a
>>>delivery and nobody batted an eye.
>> Is there any cir***stances in real life where they would actually do
>> that?
>>
>>
>Yep, but, here in the US, it has probably happened less than a half dozen
>times in a decade. It's considered to be a last resort treatment for
>shoulder dystocia (when the baby's shoulder gets stuck behind the mom's
>pubic bone after the head has delivered. Huge emergency). There are
about
>a dozen other things that would be tried first, any which of one is far
more
>likely to work, most of which Abby didn't even try before pulling out a
>knife and sawing through the pubis symphysis. I've certainly never seen
a
>symphysiotomy done ever and I've been practicing OB for 26 years, seems
>extremely unlikely that Abby, who hasn't been an OB nurse in almost a
decade
>would have ever seen the procedure, let alone known how to do it.
>
>BTW, Abby did the whole thing using just a little local anesthesia,
probably
>less than your dentist would use to fill a tooth. Yet, her patient
>seemingly didn't feel a thing and, just minutes after delivery, was
sitting
>up, holding her baby and cooing at it. In real life, the patient would
be
>in a significant amount of pain both during and afterwards and would more
or
>less have a pelvic fracture which would be disabling for weeks if not
>months. She'd need crutches and extensive therapy for recovery and runs
the
>risk of chronic pain and pelvic instability; which is why most docs
wouldn't
>even consider doing it unless every other possible option was exhausted.
>
>Symphysiotomy to treat obstructed labor is done much more commonly in the
>third world, where the facilities are not available for doing cesarians.
I
>had a med school friend who did some volunteer work in Africa and he saw
a
>couple of them done for women who had been in labor for days and were at
>risk of dying. The area where he was working didn't have OR's,
anesthesia,
>IV's, antibiotics or blood transfusions available, so the risk of dying
from
>a cesarian is very real. He said that most of the women were unable to
>spend the weeks off their feet that a symphysiotomy requires and
therefore
>healed poorly and were left with an unstable pelvis that caused them to
>wobble when they walked. He said that when they were travelling through
the
>villages, they could pick out the women who'd had a past symphysiotomy by
>their characteristic gait.
>
>Sharon
>
>>
>>
>>
Is there any reason to do it where a C-Section wouldn't be a more
desirable choice?
Also wouldn't the patient need the pelvis replaced since i'd assume
that after you do what Abbey did you'd have a patient who'd
be very apt to fall and not be able to walk?
I'd have to assume that once you saw the pelvis in half you've
got a patient who is wheel chair bound for the better part of
a year.
|
