1、King SJ, Boothroyd AE. Cranial trauma following birth in term infants. Br J Radiol 1998;71:233-8Cervical lacerationHaematomaVaginal lacerationPerineal tear Psychological traumaCrichton D. South African Medical Journal 1974;12:784-7Smellie W. A treatise on the theory and practice of Midwifery.London;
2、 MDCCLIITrial of instrumental deliveryBenefits and risksDecision-makingDr C stated that he discussed these options with Mr A and Mrs B and said that they werehappy for him to deliver their baby using forceps. Mr A and Mrs B considered that Dr Cdid not communicate very effectively with them before or
3、 during the delivery. They said itwas often very difficult to hear and understand what he was saying, particularly because DrC directed most of his comments to Ms F.Assessment: occipito-posterior position, slightly to the right; presenting part slightly tilted.Dr C applied the left blade of the forc
4、eps directly to the babys head, followed by the right blade. As the handles could not be aligned properly he removed the blades and reassessed the position of the head. At this stage, Mrs Bs buttocks were brought down further towards the edge of the bed and Dr C removed the foetal scalp electrode to
5、 enable easier application of the forceps.Dr C explained that after re-examination he was satisfied that the baby was in an occipito-posterior position and so he reapplied the forceps. He stated that this time the blades aligned without difficulty. Dr C attempted to rotate the babys head to the righ
6、t but was unable to and so attempted rotation to the left, which was also unsuccessfulWhile kneeling on the floor, Dr C applied force on the forceps during a contraction, in an attempt to pull the baby down in the occipito-posterior position while Mrs B was asked to push. Dr C explained that sometim
7、es the head can be rotated at a lower level, or delivered in that position without the need for any rotation. He stated that only moderate traction was applied during this procedure and that he only used his right forearm while his left arm was resting on top of his right hand.Mr A and Mrs B stated
8、that Dr C pulled extremely firmly on the forceps and that Mrs B was dragged down the bed as a result. Dr C denied using any more force than wasnecessary or than he would normally use during such a procedure.Other than a small laceration on the left cheek of the baby from the scalpel blade atthe time
9、 of the operation, I did not see any external forceps marks or bruises on thebabys head or the face at the time of delivery. -Dr CCord blood was obtained but had clotted and was unsuitable for pH analysis.Baby born moribund. NICU. NND.This was Mrs Bs second pregnancy and the pregnancy had been uneventful. Her first child had died of a congenital heartdefect (at 20 weeks gestation).Joint RCOG/ENTER MEETINGRisk Management and Medico-Legal Issues In Womens Health25 to 26 April 2007
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