Sunday, August 19, 2012
Friday, January 16, 2009
Wednesday, December 24, 2008
Friday, December 19, 2008
Internal Podalic Version (IPV) is an ancient procedure and was extensively practised by Hippocrates, who recommended cephalic version for all presentations other than the head. Aetius, Celsus and others at different times pointed out the fallacies of the Hippocratic teaching and the advantages of podalic version. Supported by Galen, IPV continued to be in favour till the sixteenth century. IPV had a revival that was initiated by Ambroise Pare (1510-90). Pare was the first to describe clearly and to point out the possibilities and the advantages of podalic version. About a hundred years later, an alteration in the technique of the operation was suggested by Portal – the bringing down of one leg instead of both, as was the custom up till then.
In modern obstetrics, caesarean section is the method of choice for the delivery of babies in transverse lie, and IPV is performed less frequently. While this is true in most cases, does IPV still have a role to play in modern obstetrics, or is it indeed a lost art?
There has been a drastic decrease in the number of IPVs performed on babies with transverse lie in the past decade. Hence, this study was carried to evaluate the changing trend in the mode of delivery of transverse lie, maternal and neonatal outcomes with respect to the mode of delivery and whether IPV has a role to play in the management of second twin.
A rare and potentially disastrous complication, managed successfully at a home birth.
"The waters broke and the arm dangled out. I didn't pull on the arm but tried to locate a cephalic pp (presenting part) without success. What to do? I went through the options and and decided to treat as a cord prolapse and got the woman to turn on all fours. This wasn't straightforward as she has a disability. Yet she did get there and then it flashed into my mind after a short prayer to locate the lower limb if possible and do an internal podalic version. This was done between contractions and then with legs and body dangling with the next push a gentle breech extraction was performed of a 2.3kgs baby boy."
Wednesday, December 10, 2008
A mother expecting her 11th child arrives with her daughter, who is expecting her first. Women do mending as toddlers scoot around their ankles. Childhood friends reunite, chattering in Pennsylvania Dutch. Sisters shriek with laughter at the unexpected sight of their expectant aunt."...
The world of medicine, for Goslin, is no enemy. Raised in an extended family of doctors, and the mother of a physician as well, she became interested in home birth, she explains, when a hospital-acquired infection she sustained at the birth of her oldest child left her infertile.
Seven years later and about to begin medical school herself, Goslin learned that -- in spite of her diagnosis -- she was pregnant and decided against medical school."I wanted to raise my miracle baby myself," she says. She delivered with a midwife and, believing that such care shouldn't be solely a counter cultural option, began to apprentice with a midwife...
In the Amish farmhouses of this rolling hill country, Goslin is considered family. For some women, she’s delivered a dozen babies. And, in Goslin’s own time of need, this community rallied to help – a departure for the reticent Amish who generally refuse to be photographed or be quoted by name. But on behalf of their midwife, they protested at the state capitol, staged benefits and teas, and filed an amicus brief.
An Amish mother expecting her sixth child recalls how Goslin strapped her birthing supplies on a toboggan and walked uphill to her farm when the road was impassible one winter. "I didn't even think to be worried. I figured she'd get here. She always does."