Re: [ozmidwifery] question

[Susan Cudlipp]

Good point Anne!   I did quite a thorough search last night and have printed off some good articles which I will pass on.  However I could not find the answer to why EXACTLY babies die in shoulder dystocia.  If it is asphyxia, then (obs point of view) this proves that the cord is not sustaining them. The ob said to me that if the cord WERE sustaining them there would be no urgency to deliver the body, also quoted from the ALSO course that the fetal Ph drops 0.04 (?)  per minute after delivery of head therefor we should not be waiting for restitution but delivering body ASAP.  (I didn't even go there!!) My feeling is that it is more to do with probable cord compression, (although I cannot picture why this should necessarily be so as the body and hence, presumably, the cord, would still be above the pelvic brim) and trauma to the neck usually caused by mis-management (panic) in trying to deliver the shoulders than asphyxia, but it is true that they become asphyxiated within a short time if truly stuck.  Any answers on that one? Thanks Sue   "The only thing necessary for the triumph of evil is for good men to do nothing" Edmund Burke ----- Original Message ----- From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Thursday, November 17, 2005 5:54 AM Subject: Re: [ozmidwifery] question Dear Susan,   You could say to them if this is so why do they rely so much on cord ph's ?  One would think when the baby was born and the pulsating cord was still not supplying the baby effectively the cord blood (venous and arterial) was null and void to provide an estimation of oxygenation for the babe.   Regards Anne Clarke Queensland ----- Original Message ----- From: Susan Cudlipp To: midwifery list Sent: Wednesday, November 16, 2005 9:30 PM Subject: [ozmidwifery] question I have a question for you wise ozmidders. I was having a discussion today with one of our obstetricians regarding cord clamping, and the benefits to the baby of delaying this until pulsations cease.  When I mentioned the benefit of the baby recieving oxygenated blood via the pulsating cord which could assist it's transition to independent respiration particularly if it was compromised (etc etc)  the obs was of the view that the pulsations could NOT be providing oxygenated blood because the uterus would have contracted down and the placenta could no longer be getting oxygen from mother's circulation. Now I know that I have read reams on this and this is stated to be one of the benefits, but I could not answer that particular question physiologically and convincingly. The point was also raised that in shoulder dystocia, babies die of asphyxiation, which (obs opinion) would not happen if they were recieving oxygen via the cord.  I did print off George Morley's excellent papers for this Dr to read but would very much welcome anything that can show that the baby would still be receiving oxygenated blood post birth.   TIA Sue     "The only thing necessary for the triumph of evil is for good men to do nothing" Edmund Burke __________ NOD32 1.1289 (20051116) Information __________ This message was checked by NOD32 antivirus system. http://www.eset.com No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.362 / Virus Database: 267.13.3/173 - Release Date: 16/11/2005