Rachel, i am preparing to do a talk to the midwives and possible obs at my hospital at the moment on early vs delayed cord clamping, and one of the main reasons they use to back up their routine practice of early cord clamping is the need for routine cord blood analysis after EVERY birth. do you know where i could get any info that might help back up the argument against this? i have lots of info on the benefits of delayed cord clamping but i know there will be lots of counter arguments... Liz
-----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of wump fish Sent: Friday, 18 November 2005 11:49 AM To: [email protected] Subject: Re: [ozmidwifery] question I agree with you Andrea. I think many babies are literally strangled during true shoulder dystocias. As for cord ph - I can clearly remember a baby having a lovely normal cord ph following his death during a shoulder dystocia (????). Provided me with yet more ammunition against the hospital's policy of routine cord gas analysis following all births. Rachel >From: Andrea Quanchi <[EMAIL PROTECTED]> >Reply-To: [email protected] >To: [email protected] >Subject: Re: [ozmidwifery] question >Date: Thu, 17 Nov 2005 17:22:52 +1100 > >You only have to watch the colour change to the head to know whether >circulation is compromised or not. Some ( most ) babies stay pink and or >only slightly dusky but others go almost navy blue and even get >subconjuntival haemorrhages similar to those that occur in hanging victims >which to me indicates that circulation to the head has been compromised for >at least some time. Babies can tolerate this for a period but eventually >it must have an effect. Just from observation I would say this has little >to do with cord compression but compression of the foetal neck by maternal >structures which would occur more severely in true shoulder dystocia. Of >course prevention is better than cure and encouraging 25% increase in space >within the maternal pelvis is likely to reduce the number of cases where >this will be a problem. > >Andrea Quanchi >On 17/11/2005, at 4:02 PM, Susan Cudlipp wrote: > >>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: [email protected] >>>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 _________________________________________________________________ MSN Messenger 7.5 is now out. 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