Dear Lynne Does your example also suggest that response of not attempting a manual removal but cut off the cord flush with the placenta, and left it in > situ to regress
?may avoid hysterectomy for some placenta accreta which currently happens??? Thinking out loud (again) Denise ----- Original Message ----- From: "Lynne Staff" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Saturday, March 29, 2003 1:24 PM Subject: Re: [ozmidwifery] risks of 4th c/s and support for artificial feeding > Hi Marilyn - I always love your postings! > > You reminded me of a case study I read some years ago of a woman who > presented with very obvious haematuria in pregnancy. She had had two > previous caesareans from memory. > The diagnosed placenta percreta, which had extended into the bladder, the > cause of the bleeding. > > At caesarean, they cut off the cord flush with the placenta, and left it in > situ to regress for a week (I think)- any attempt to remove it at the caesar > would have resulted in major complications. > > They removed it a week later from memory and the woman was fine. If you > think about abdominal pregnancy, the placenta usually has to be left in situ > to regress because it secures itself to all sorts of places, and to remove > it is impossible. So, after time it is slowly absorbed. I often wonder about > the initiation of lactation though, and how these women and their babies > fare. > ----- Original Message ----- > From: "Marilyn Kleidon" <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Sent: Sunday, March 30, 2003 3:06 AM > Subject: Re: [ozmidwifery] risks of 4th c/s and support for artificial > feeding > > > > Dear Lois, Lynne and others: > > > > I agree we must inform the women of these risks however they can be > > accessed. AND we also need to make in-roads into the obstetric community. > I > > have spoken to several women postnatally who really wanted either a vbac > or > > a vaginal breech birth (multips with prior NVB's)but were scared off by > > their ob. The ob's even used their lack of experience in these areas and > > their extensive experience with c/s to justify the elective caesarean. One > > young woman who had an emergency caesar for FTP and CPD due to malposition > > was advised from immediately after that birth to have a repeat caesar and > > when she persisted with her desire for a vaginal birth the dangers of > > shoulder dystocia were brought up. So that now she is terrified if she > tried > > for a vaginal birth the baby could be damaged and she would never forgive > > herself. These are women who really don't want major surgery but have been > > made to feel that caesarean birth is the safest route for their baby and > > feel they would be being selfish if they pursued a vaginal birth. Once the > > fear and guilt are there it is so hard to override. So, I guess I am > saying > > the ob's are giving out misinformation which they may really believe, but > > neverthless misinforms women. Somehow they (ob's, hospitals)need to become > > afraid of doing unnecessary caesareans. I think we need some good research > > that gets published in ob journals. > > > > marilyn > > > > ----- Original Message ----- > > From: "Lois Wattis" <[EMAIL PROTECTED]> > > To: <[EMAIL PROTECTED]> > > Sent: Friday, March 28, 2003 3:44 PM > > Subject: Re: [ozmidwifery] risks of 4th c/s and support for artificial > > feeding > > > > > > > Dear Lynne and others on this subject > > > I agree this information needs to be given to women antenatally in > > whatever > > > location they can be accessed. Problem is, women planning C.S. for > > whatever > > > reason frequently don't attend any antenatal education because they > > consider > > > they do not need it (not planning labour), so they are missed. Their > > total > > > exposure to 'education' is what they get from the ob (!!!) usually > scant > > at > > > best. > > > > > > Another common situation is that they are not 'planning' another > pregnancy > > > so discount the potential consequences abnormal placental implantation > in > > a > > > subsequent pregnancy. We all know some pregnancies occur - > unplanned.... > > > Women tend to hear what they want to, and discount the info they feel > does > > > not apply to them. I also find they (elective C.S. candidates) often > know > > > NOTHING of the potential risk for endometrial problems related to their > > > scarred uterus.... another subject infrequently discussed in the "ob. > > > education" process. Unfortunately, so many of the elective C.S. women > are > > > NOT making truly informed choices. (sigh) Lois > > > > > > ----- Original Message ----- > > > From: "Lynne Staff" <[EMAIL PROTECTED]> > > > To: <[EMAIL PROTECTED]> > > > Sent: Saturday, March 29, 2003 6:53 AM > > > Subject: Re: [ozmidwifery] risks of 4th c/s and support for artificial > > > feeding > > > > > > > > > The potential for placental problems does not seem to be discussed with > > > women when they are booking in for repeat caesareans. When I speak with > > > women who are having elective repeat caesareans, they seem unaware that > > this > > > may be a consequence of this choice. As a result of this, this > information > > > is included in antenatal classes when discussing caesarean birth and > also > > in > > > the VBAC and caesarean class. > > > ----- Original Message ----- > > > From: "Marilyn Kleidon" <[EMAIL PROTECTED]> > > > To: <[EMAIL PROTECTED]> > > > Sent: Sunday, March 30, 2003 1:33 AM > > > Subject: Re: [ozmidwifery] risks of 4th c/s and support for artificial > > > feeding > > > > > > > > > > Hi Sarah: I just wanted to add a note about the increased risks of > > > placenta > > > > previa, accreta, and percreta which are real risks to a populatiuon of > > > women > > > > who have had prior cesarean birth(s). However they really don't tell > us > > > > anything about this woman's actual risk. If she has had problems with > > > > removal of the placenta after her previous cesareans then maybe this > can > > > be > > > > checked out with u/s as this would tell us valuable info. We had a mum > > in > > > > for an elective repeat caesar the other week who had a known placenta > > > > percreta (had been checked by u/s as having not grown through to the > > > > bladder). There were extensive precautions taken to avoid an obstetric > > > > disaster and they did. I think the risk of women having these > placental > > > > problems after c/s is a bit like women's risk of developing kelloid > > > growths > > > > after ear piercings: some of us will never develop them (0% actual > risk) > > > and > > > > others will always develop them (100% actual risk), but we don't know > an > > > > individuals actual response until after the event, so all we can give > is > > a > > > > population risk. > > > > > > > > I think an outcome of the increasing number of caesars occuring right > > now > > > is > > > > this increased risk of retained placentas (accretas etc..) due to > > uterine > > > > scarring. Since we have not done this before I think we simply don't > > know > > > > what the risks of this particular outcome occuring will be. > > > > > > > > marilyn > > > > ----- Original Message ----- > > > > From: "Lynne Staff" <[EMAIL PROTECTED]> > > > > To: <[EMAIL PROTECTED]> > > > > Sent: Friday, March 28, 2003 1:16 AM > > > > Subject: Re: [ozmidwifery] risks of 4th c/s and support for artificial > > > > feeding > > > > > > > > > > > > > Hi Sarah - has she considered labouring and giving birth? > > > > > ----- Original Message ----- > > > > > From: "sarah.darling" <[EMAIL PROTECTED]> > > > > > To: "Ozmidwifery" <[EMAIL PROTECTED]> > > > > > Sent: Thursday, March 27, 2003 4:03 PM > > > > > Subject: [ozmidwifery] risks of 4th c/s and support for artificial > > > feeding > > > > > > > > > > > > > > > > Recent new subscriber here. I'm a community midwife in England and > > am > > > > > really > > > > > > struggling to find research on the risks of a 4th c/s as opposed > to > > > any > > > > > > other number c/s (i.e. what are the increased risks of a 4th c/s, > if > > > > any, > > > > > so > > > > > > that one of 'our' women can make a decision whether to try for a > 4th > > > > baby > > > > > as > > > > > > she has been told that 4 x c/s is 'too dangerous' - her quote). > Also > > > > does > > > > > > anyone know of any research asking women whether, if they chose to > > > > > > artificially feed their baby, they received support/teaching in > > making > > > > up > > > > > > feeds, etc., singly or in groups. This is for a senior student and > > her > > > > > > dissertation. Really enjoying all the wisdom out there! Best > wishes > > > > > > Sarah Darling > > > > > > [EMAIL PROTECTED] > > > > > > Community midwife > > > > > > > > > > > > > > > > > > -- > > > > > > This mailing list is sponsored by ACE Graphics. > > > > > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > > > > > > > -- > > > > > This mailing list is sponsored by ACE Graphics. > > > > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > > > > > > > > > > > > > > -- > > > > This mailing list is sponsored by ACE Graphics. > > > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > > > -- > > > This mailing list is sponsored by ACE Graphics. > > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > > > -- > > > This mailing list is sponsored by ACE Graphics. > > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > > > > > > -- > > This mailing list is sponsored by ACE Graphics. > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
