[ozmidwifery] use of IV syntocinon during late 2nd stage haemmorhage
Hi all, Just wanted to ask a question regarding the use of IV synto during a late 2nd stage haemmorhage. I was with a woman the other day (i'm a student mid) who was experiencing a VBAC and the woman was losing alot of blood. She had been given IV synto at a rate of 30ml/hr and as the woman started to bleed, the midwife turned up the synto to the maximum rate apparently to reduce the haemmorhage. I've never seen this done before, and was wondering what the knowledgeable midwives :) on this lists thoughts are? The woman ended up losing prob 800ml of blood (and the new mid forgot to give syntometrine injection). Sam 02_header.gif Description: GIF image 02.gif Description: GIF image
RE: [ozmidwifery] use of IV syntocinon during late 2nd stage haemmorhage
Hi Sam Am a bit confused...was the baby born? If not how much head was on view? Often these last minute 'bleeds' can come from the vaginal wall or cervix for which increasing the synto would be useless. Lisa -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Samantha Saye Sent: Monday, 27 November 2006 8:51 AM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] use of IV syntocinon during late 2nd stage haemmorhage Hi all, Just wanted to ask a question regarding the use of IV synto during a late 2nd stage haemmorhage. I was with a woman the other day (i'm a student mid) who was experiencing a VBAC and the woman was losing alot of blood. She had been given IV synto at a rate of 30ml/hr and as the woman started to bleed, the midwife turned up the synto to the maximum rate apparently to reduce the haemmorhage. I've never seen this done before, and was wondering what the knowledgeable midwives :) on this lists thoughts are? The woman ended up losing prob 800ml of blood (and the new mid forgot to give syntometrine injection). Sam http://www.incredimail.com/index.asp?id=96766 Add FUN to your email - CLICK HERE! 02_header.gif Description: GIF image 02.gif Description: GIF image
RE: [ozmidwifery] use of IV syntocinon during late 2nd stage haemmorhage
No, the baby wasnt born, but the head was on view. The midwife upped the rate of synto while the woman was pushing. sam ---Original Message--- From: LJG Date: 11/27/06 12:13:37 To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] use of IV syntocinon during late 2nd stage haemmorhage Hi Sam Am a bit confused...was the baby born? If not how much head was on view? Often these last minute 'bleeds' can come from the vaginal wall or cervix for which increasing the synto would be useless. Lisa -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Samantha Saye Sent: Monday, 27 November 2006 8:51 AM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] use of IV syntocinon during late 2nd stage haemmorhage Hi all, Just wanted to ask a question regarding the use of IV synto during a late 2nd stage haemmorhage. I was with a woman the other day (i'm a student mid) who was experiencing a VBAC and the woman was losing alot of blood. She had been given IV synto at a rate of 30ml/hr and as the woman started to bleed, the midwife turned up the synto to the maximum rate apparently to reduce the haemmorhage. I've never seen this done before, and was wondering what the knowledgeable midwives :) on this lists thoughts are? The woman ended up losing prob 800ml of blood (and the new mid forgot to give syntometrine injection). Sam 02_header.gif Description: GIF image 02_header1.gif Description: GIF image 02.gif Description: GIF image
Re: [ozmidwifery] use of IV syntocinon during late 2nd stage haemmorhage
My thinking on this one is that perhaps if the contractions were infrequent ie 5 mins apart, the midwife may have been seeking to increase the number of contractions, therefore increasing pushing opportunities to reduce the length of time til the baby was born therefore reducing the blood loss. Sometimes we (experienced midwives) can say things like 'to reduce the blood loss' when that is the end domino result of what our actions are - not a direct cause/effect if you know what I mean and that is confusing to beginner practitioners - we have the whole scene played out in our heads like holographic images, but as beginners we only have 'join the dots' fine lines of information and understanding. Sam, did you ask the midwife to explain her actions to you? It would be good to go back and ask her exactly what she did and what were the things she was thinking? Frame it from the point of view that you are learning and are trying to understand the step by step decision making process so you can think like that. She may, of course, find it difficult to articulate her reasoning because as the novice to expert four stage process (described by Dubin 1972) goes, the end stage expert behaviour is mostly unconscious patterns of behaviour. warmly, Carolyn - Original Message - From: Samantha Saye To: ozmidwifery@acegraphics.com.au Sent: Monday, November 27, 2006 2:49 PM Subject: RE: [ozmidwifery] use of IV syntocinon during late 2nd stage haemmorhage No, the baby wasnt born, but the head was on view. The midwife upped the rate of synto while the woman was pushing. sam ---Original Message--- From: LJG Date: 11/27/06 12:13:37 To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] use of IV syntocinon during late 2nd stage haemmorhage Hi Sam Am a bit confused...was the baby born? If not how much head was on view? Often these last minute 'bleeds' can come from the vaginal wall or cervix for which increasing the synto would be useless. Lisa -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Samantha Saye Sent: Monday, 27 November 2006 8:51 AM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] use of IV syntocinon during late 2nd stage haemmorhage Hi all, Just wanted to ask a question regarding the use of IV synto during a late 2nd stage haemmorhage. I was with a woman the other day (i'm a student mid) who was experiencing a VBAC and the woman was losing alot of blood. She had been given IV synto at a rate of 30ml/hr and as the woman started to bleed, the midwife turned up the synto to the maximum rate apparently to reduce the haemmorhage. I've never seen this done before, and was wondering what the knowledgeable midwives :) on this lists thoughts are? The woman ended up losing prob 800ml of blood (and the new mid forgot to give syntometrine injection). Sam 02_header.gif Description: GIF image 02_header1.gif Description: GIF image 02.gif Description: GIF image
