anyone seeing this maneuver?

[ragingmomster]

We have recently seen an increase in a maneuver where the doctor will use an SVE to push upward on the chin of an OA presentation baby to increase descent in the birth canal.

Unfortunately I can't remember the name of the manuever at this time.

[3Angels]

My orifice clinches just thinking about it.:angryfire

[christine_chapel]

If this maneuver were performed on me without both the presence of fetal distress AND informed consent, then I think I would end up "accidentally" kicking someone in the face.

[LandDRN]

I have seen this done but only to stabalize the decent of the head if "turtling" is a problem. Not a routine or even frequent practice here.

[Nefertari1279]

Unless I was ASKED FIRST, the Dr would get a nice fat kick in the face or groin if they did that.

Sorry that is just not happening, LOL

[Selke]

I have seen this done but only to stabalize the decent of the head if "turtling" is a problem. Not a routine or even frequent practice here.

??? "Turtling" is associated with shoulder dystocia. It's the first sign of a problem. The anterior shoulder can't get past the symphysis pubis, so the head retracts.

You may be referring to applying counterpressure to the baby's head to slow down a fast explusion, to help prevent tears. You can apply gentle, even pressure over the emerging vertex to keep it from popping out, if baby is coming really fast. You are not trying to change the direction of expulsion of the head as with Ritgen or flexion, you are just trying to slow it down a bit.

There are controversial maneuvers that some believe prevent lacerations, but research shows they do not do these things and it's best to let nature take its course. There is a technique of flexion, applying downward pressure over the vertex, to prevent periurethral lacs, but this is controversial. Studies show that modified Ritgens and flexion create more problems than they purport to solve. The diameter of fetal skull that emerges in a normally flexed position is the smallest possible diameter. The woman's body, and the baby, know what they are doing :) There are many research articles on these topics.

[LandDRN]

??? "Turtling" is associated with shoulder dystocia. It's the first sign of a problem. The anterior shoulder can't get past the symphysis pubis, so the head retracts.

You may be referring to applying counterpressure to the baby's head to slow down a fast explusion, to help prevent tears. You can apply gentle, even pressure over the emerging vertex to keep it from popping out, if baby is coming really fast. You are not trying to change the direction of expulsion of the head as with Ritgen or flexion, you are just trying to slow it down a bit.

There are controversial maneuvers that some believe prevent lacerations, but research shows they do not do these things and it's best to let nature take its course. There is a technique of flexion, applying downward pressure over the vertex, to prevent periurethral lacs, but this is controversial. Studies show that modified Ritgens and flexion create more problems than they purport to solve. The diameter of fetal skull that emerges in a normally flexed position is the smallest possible diameter. The woman's body, and the baby, know what they are doing :) There are many research articles on these topics.

Yes, I know that. And I did not say I agreed with the OBs decision for this proceedure. It was a dystocia case and we promptly wrote him up several times. He only practiced for 8 months at our hospital after receiving "counselling." I was just stating that this was the only time I've seen it and that was his rational given. He stated he felt that it would help provent the head from receeding after the push was completed. Hense why I stated this was not a common practice here ( AKA no one else did it and I only saw it used twice.)

[Dayray, RN]

it a good manouver in the right situation but like many interventions is misused quit offten. I have mixed feelings on informed consent on this one, as if it is nessasary time is of the essence. If only people could know OBs well enough to know weather or not to trust their judgment. its unfortante but most dont know their docs that well and many docs arent worthy of that trust.

Ive seen allot of docs use it, pateints dont useualy notice