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Shoulder dystocia
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Randall C. Floyd, James S. Smeltzer
The reader can find many other maneuvers that have been described for the treatment of shoulder dystocia, and other variations of those presented. The ones presented here have either been observed by the authors to be effective without injury or are theoretically likely to be effective biomechanically (hands-and-knees position) and have been reported to be safe and effective. The other maneuvers that may be safe and effective are (i) fracture of the clavicle, often the result of sharply applied suprapubic pressure but usually much more difficult to accomplish than anticipated and (ii) symphysiotomy, which is simple, rapid, and effective (14) though usually outside of the scope of practice of most providers.
Assisted Vaginal Breech Delivery
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Malik Goonewardene
The fetal head could become stuck inside the pelvis due to fetopelvic disproportion, if a proper selection of cases has not been made. Symphysiotomy (described in Chapter 10) and caesarean delivery have been described as possible methods for the delivery of the fetus in this case. However, these methods are associated with considerable morbidity for the woman.
Man-midwives on the childbirth scene
Published in Nadia Maria Filippini, Clelia Boscolo, Pregnancy, Delivery, Childbirth, 2020
This was a phase of intense experimentation of various obstetric operations, some of which, after their initial success, were abandoned, as they were shown to be useless or harmful. This is the case, for example, with symphysiotomy, the cutting of the pubic cartilage to widen a woman’s pelvic opening in cases of extreme narrowness. Proposed by Jean-René Sigault, it was performed for the first time on a living woman in Paris on 2nd October 1777, with the assistance of Alphonse Leroy. It provoked such enthusiasm that the two inventors were awarded silver medals by the Paris Faculty of Medicine, while “a symphysiotomy epidemic” spread in France, and also in Holland and Spain. In Italy, it was promoted by Girolamo Personé in his Trattato della sezione della sinfisi del pube e del taglio cesareo (Treatise on symphysiotomy and on Caesarean section), from 1781.22 The continuation of this experiment showed how misplaced this trust was and how dangerous and debilitating the intervention was for women: out of 42 women who had undergone the procedure, 15 died in Paris in the next few years and others were permanently disabled.23
Outcome of anastomotic urethroplasty in traumatic stricture (distraction defect) of posterior urethra in boys
Published in Arab Journal of Urology, 2020
Ghulam Mujtaba Zafar, Sikandar Hayat, Javeria Amin, Fawad Humayun
In the present study, transpubic urethroplasty was performed in seven boys (18.42%) who had long distraction defects of >4 cm (range 4.1–7.0 cm) and all were successful without significant haemorrhage, gait abnormality, hernia or chronic pain. Patil [14] followed five of 30 patients for 7–10 years after transpubic urethroplasty and found all competent and continent. Das et al [15] operated on 10 children using transpubic approach with 100% success rate. Basiri et al [16] reported symphysiotomy in 10 children (both boys and girls); all were successful and continent without any complications. Podesta and Podesta [17] did a comparative study of perineal vs transpubic urethroplasty for traumatic posterior urethral distraction defect in children and found a stricture-free rate of 84% for the perineal approach and 100% in those who underwent transpubic urethroplasty.