Hi Lisa sorry didn't mean to reply as I did, am abit passionate about
this..have pmed you a copy of the bmj paper which talks about this..I think
what they are saying is that the 'belief' about the overload of blood with
the oxytocic hasn't been proven maybe!? Have read lots of old stuff about
the hyperviscosity/overload theories but as I say these were old and many ?
Opinion based...look forward to what you can dig up.... !
The paper is geared towards developing countries where babies are more
likely to suffer from anaemia but I think it is pertinent to developed
countries too.
Lisa

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lisa Barrett
Sent: Tuesday, 14 November 2006 5:12 PM
To: [email protected]
Subject: Re: [ozmidwifery] Delaying synto with active third stage


Hi Lisa, Delaying the Syntocinon until after the cord has stopped pulsing 
isn't a problem as up until you give the drug you are treating it as a 
physiological third stage.  giving the drug then just waiting for the cord 
to stop could be a problem.  When I have a few mins I'll check it out I'm 
pretty sure there's something on the rush of blood caused and the transfer 
of the drug in connection with Jaundice.
I realise that some women opt for active third stage but if they've gone as 
far as letting the cord stop with no bad effect it seems a shame not to 
continue.
I wasn't implying that there was information that you weren't aware of :-)
Lisa Barrett
----- Original Message ----- 
From: "LJG" <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Tuesday, November 14, 2006 4:55 PM
Subject: RE: [ozmidwifery] Delaying synto with active third stage




Well that's what we've always been led to believe, but it's not a one way
system is it? So if you are using syntocinon (not syntometrine where the
contraction is much stronger and more sustained) why won't the baby regulate
it's own blood volume? I am speaking from hospital experience where active
is the norm and where in some births the cord is clamped so quickly  even
before the kid has taken a gasp! And funnily enough we do actually have
women who have 'unmanaged' first/second stages and opt for active third
stages..so why not wait for a bit before giving the oxytocic and
clmaping...this is what I see no harm in..and am aware of the need to not
mix methods i.e cct with physiological Lisa


Why would you do that Lisa?  if you give an oxytocic you get a surge of
blood through the cord.  The uterus contracts within 3 mins Syntocinon 7/9
mins ergometrine.  The Placenta should be sheared off the wall within
minutes.  If you want the cord to stop pulsating in a well new born surely
the way to go is a physiological third stage.  Half way house between both
is a recipe for disaster . Physiological first and second stage =
physiological third stage. Managed first and second stage= active third
stage.

Lisa Barrett
----- Original Message ----- 
From: "LJG" <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Tuesday, November 14, 2006 12:26 PM
Subject: [ozmidwifery] Delaying synto with active third stage


Hi Sue this is something I have always been interested in....the link is to
the FIGo/ICM Joint statement on active third stage and it states you can
leave the cord in a well newborn to stop pulsating...and then cut; this is
with giving the oxytocic at birth......


http://www.sogc.org/guidelines/public/136E-JPS-November2003.pdf

There was also  a paper on delayed cord clamping and its benefits in the BMJ
a few weeks back.....it sites the above statement and promotes a delay in
cord clamping even in active third stage Regards Lisa


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