Dialogue Volume 13 Issue 3 2017 - Page 44

PRACTICE PARTNER β€’ It would have been appropriate to put a plan in place when the woman presented in labour. It is currently believed that delivery by elective Cesarean section for suspected fetal macrosomia has not been proven to be protective for the fetus/n •½Ή…Ρ”°…Ή)Ρ‘”‘•₯Ν₯½ΈΡΌΑΙ½••έ₯Ρ „Ω…₯Ή…°‘•±₯Ω•Ιδέ…Μ)Ι•…Ν½Ή…‰±”Έ•±₯Ω•Ι䁉δΩ…ΥΥ΄•αΡΙ…Ρ₯½Έ΅…䁉”)…ΝΝ½₯…Ρ•έ₯Ρ Ν‘½Υ±‘•Θ‘εΝΡ½₯„₯Ή‘•Α•Ή‘•ΉΠ½˜)™•Ρ…°έ•₯‘ΠΈ+Šˆ€Q‘”½‰ΝΡ•ΡΙ₯₯…Έ½Έ…±°έ…Μ€ΠΤ΄Ψΐ΅₯ΉΥѕ́…έ…δ)…Ёё”Ρ₯΅”½˜Ρ‘”•΅•Ι•Ήδ½ΉΝΥ±Ρ…Ρ₯½ΈΈQ‘₯Μ)Ι•ΝΑ½ΉΝ”Ρ₯΅”έ…́₯Ή…‘•ΕΥ…Ρ”Έ]₯Ρ •…Ι±₯•ΘΉ½Ρ₯™€΄)…Ρ₯½Έ½˜Ρ‘”Ι₯Ν¬½˜Ν‘½Υ±‘•Θ‘εΝΡ½₯„°Ρ‘”½‰ΝΡ•ΡΙ€΄)₯…Έ½Υ±‘…Ω”‰••Έ±½Ν•ΘΡΌΡ‘”‘½ΝΑ₯Ρ…°Έ]₯Ρ )•…Ι±₯•Θ½ΉΝΥ±Ρ…Ρ₯½Έ…Ёё”Ρ₯΅”έ‘•ΈΡ‘”‘…Ή”)₯Έ™•Ρ…°‘•…ΙЁɅєέ…́™₯ΙΝЁΉ½Ρ•°Ρ‘•Ι”½Υ±…±ΝΌ)‘…Ω”‰••Έ•…Ι±₯•Θ₯ΉΡ•ΙΩ•ΉΡ₯½Έ‰δ…Έ½‰ΝΡ•ΡΙ₯…°)ΑΙ½Ω₯‘•ΘΝ­₯±±•₯Έ‰½Ρ …ΝΝ₯ΝΡ•Ω…₯Ή…°‘•±₯Ω•Ιδ)…Ή •Ν…Ι•…ΈΝ•Ρ₯½ΈΈ+Šˆ€Q‘•Ι”έ…́ΉΌ‘½Υ΅•ΉΡ•‘₯͍ΥΝΝ₯½Έέ₯Ρ Ρ‘”)΅½Ρ‘•Θ½Ή•ΙΉ₯Ήœ‰₯ΙΡ ₯Έ„1•Ω•°€Δ‘½ΝΑ₯Ρ…°)έ‘•Ι”•΅•Ι•Ήδ½‰ΝΡ•ΡΙ₯…°Ν•ΙΩ₯•Μέ•Ι”Ή½Π)₯΅΅•‘₯…Ρ•±δ…Ω…₯±…‰±”…ΉΑ‘εΝ₯₯…ΉΜέ•Ι”Ή½Π)Ι•ΕΥ₯Ι•ΡΌΙ•΅…₯Έ½ΈΝ₯Ρ”έ‘₯±”½Έ…±°™½Θ½ˆ΄)ΝΡ•ΡΙ₯…°½ΉΝΥ±Ρ…Ρ₯½ΉΜ…Ή‰₯ΙΡ‘ΜΈΩ…₯±…‰₯±₯Ρ䁽˜)•΅•Ι•Ήδ½‰ΝΡ•ΡΙ₯…°Ν•ΙΩ₯•ΜΝ‘½Υ±‘…Ω”‰••Έ)½ΉΝ₯‘•Ι•‰•™½Ι”…ΡΡ•Ή‘₯ΉœΡ‘₯́1•Ω•°€Δ‘½ΝΑ₯Ρ…°)έ₯Ρ „έ½΅…Έέ₯Ρ „±…ɝ”™½Θ•ΝΡ…Ρ₯½Ή…°…”™•ΡΥΜ)…Ήέ₯Ρ „ΑΙ•Ω₯½ΎΝ₯΅₯±…ȁ‘₯ΝΡ½ΙδΈ)I•½΅΅•Ή‘…Ρ₯½ΉΜθ(ΔΈ!½ΝΑ₯Ρ…±ΜΑΙ½Ω₯‘₯Ήœ •Ν…Ι•…ΈΝ•Ρ₯½ΈΝ•ΙΩ₯•Μ)Ν‘½Υ±‰”…‰±”ΡΌ΅½ΥΉΠΡ‘”ΑΙ½•‘ΥΙ”έ₯Ρ‘₯Έ…ΐ΄)ΑΙ½α₯΅…Ρ•±δ€Μΐ΅₯ΉΥѕ́™Ι½΄Ρ‘”Ρ₯΅”½˜‘•₯Ν₯½ΈΡΌ)ΑΙ½••Έ(ΘΈ=‰ΝΡ•ΡΙ₯…°…Ι”ΑΙ½Ω₯‘•Ί…Ι”Ι•΅₯Ή‘•½˜Ρ‘”)₯΅Α½ΙΡ…Ή”₯Έ₯‘•ΉΡ₯™ε₯ΉœΙ₯Ν¬™…Ρ½Ί…Ή™½ΘΡ₯΅•±δ)…Ή±•…ȁ½΅΅ΥΉ₯…Ρ₯½Έέ₯Ρ Ρ‘”•ΉΡ₯Ι”±…‰½Υȁ…Ή)‘•±₯Ω•ΙδΡ•…΄Έ=‰ΝΡ•ΡΙ₯…°…Ι”ΑΙ½Ω₯‘•Ί΅ΥΝЁ‰”)…έ…Ι”½˜Ρ‘”…Ω…₯±…‰₯±₯Ρ䁽˜½‰ΝΡ•ΡΙ₯Œ°…Ή•ΝΡ‘•Ν₯„°)Ή•½Ή…Ρ…°…Ή½Α•Ι…Ρ₯ΉœΙ½½΄ΝΡ…™˜Έ(ΠΠ)%1=U%MMU€Μ°€ΘΐΔά(ΜΈ=‰ΝΡ•ΡΙ₯…°…Ι”ΑΙ½Ω₯‘•Ί…Ι”•Ή½ΥΙ…•ΡΌ)Ι•Ω₯•ά•Ρ…°!•…±Ρ MΥΙΩ•₯±±…Ή”聹ѕΑ…ΙΡΥ΄…Ή)%ΉΡΙ…Α…ΙΡΥ΄ ½ΉΝ•ΉΝΎΥ₯‘•±₯Ή”°)= °Y½±Υ΅”(Θ䰁9Υ΅‰•Θ€δ°M•ΑΡ•΅‰•Θ€ΘΐΐάΈ(ΠΈ!½ΝΑ₯Ρ…°‘•…±Ρ ΅…Ι”ΑΙ½™•ΝΝ₯½Ή…±Μ₯Έ1•Ω•°€Δ)₯ΉΝΡ₯ΡΥΡ₯½ΉΜέ‘•Ι”½‰ΝΡ•ΡΙ₯…°…Ι”₯́‰•₯ΉœΑΙ½Ω₯‘•)Ν‘½Υ±‰”•Ή½ΥΙ…•ΡΌ…ΡΡ•Ή‘Ω…Ή•Μ₯Έ1…‰½ΥΘ)…ΉI₯Ν¬5…Ή…•΅•ΉΠ€‘1I4€…Ή9•½Ή…Ρ…°I”΄)ΝΥ͍₯Ρ…Ρ₯½ΈAΙ½Ι…΄€‘9I@€½Θ•ΕΥ₯Ω…±•ΉΠΡΙ…₯Ή₯Ήœ½Έ)„Ι•Υ±…ȁ‰…Ν₯ΜΈ(¨¨¨¨¨¨¨¨¨¨)%ΈΡ‘”Ν•½Ή…Ν”Ι•Ω₯•έ•‰δΡ‘” ½΅΅₯ΡΡ•”°…Έ₯Ή™…ΉΠ)‘₯•…ЁΡέΌ‘…έ½˜…”…™Ρ•Θέ₯Ρ‘‘Ι…έ…°½˜±₯™”΅ΝΥΝΡ…₯Ή₯Ήœ)΅•‘₯…°Ρ‘•Ι…Α䁙½±±½έ₯Ήœ±•…ȁ•Ω₯‘•Ή”½˜Ν•Ω•Ι”•ΉΡΙ…°)Ή•ΙΩ½ΎΝεΝΡ•΄₯Ή©ΥΙ丁!”‘…ΝΥΝΡ…₯Ή•‰₯±…Ρ•Ι…°Ν­Υ±°)™Ι…ΡΥɕ́‘ΥΙ₯Ήœ‰₯ΙΡ …́„Ι•ΝձЁ½˜•™™½ΙΡ́Ѽ•αΡΙ…Π‘₯Μ)‘•…™Ι½΄Ρ‘”Α•±Ω₯́‘ΥΙ₯Ήœ…Έ•΅•Ι•Ήδ •Ν…Ι•…Έ)Ν•Ρ₯½ΈΈ5…ΉΥ…°ΑΙ•ΝΝΥΙ”•α•ΙΡ•‘₯Ι•Ρ±δ……₯ΉΝЁё”Ν½™Π)Ή•½Ή…Ρ…°Ν­Υ±°΅…δΙ•ΝձЁ₯Έ‘₯Ι•Π°‰±ΥΉΠΡΙ…Υ΅„ΡΌΡ‘”)ΥΉ‘•Ι±ε₯Ήœ‰Ι…₯Έ…ΉΩ…͍ձ…ȁΝΡΙՍΡΥΙ•ΜΈQ‘₯́‘•Ι•”½˜)ΑΙ•ΝΝΥΙ”…Έ‰”ΥΉ­Ή½έ₯Ή±δ…ΑΑ±₯•έ‘•ΈΡ‘•Ι”₯́…Έ)Υɝ•ΉΠΉ••ΡΌ…™™•Π‘•±₯Ω•Ι䁅ΉΡ‘”‘•…₯́₯΅Α…Ρ•Έ)Q‘”‘₯™™₯Υ±Π‘•±₯Ω•Ι䁽˜Ρ‘”™•ΡΎ…Ёё”Ρ₯΅”½˜ •Ν…Θ΄)•…ΈΝ•Ρ₯½Έ₯́Ή½ΠΥΉ½΅΅½Έ°Α…ΙΡ₯Υ±…Ι±δ₯Έ…‘Ω…Ή•)±…‰½ΥΘΈΉΡ₯₯Α…Ρ₯½Έ½˜Ρ‘₯́‰δΡ‘”…ΡΡ•Ή‘₯Ήœ½‰ΝΡ•ΡΙ₯…°)Ρ•…΄₯́•αΡΙ•΅•±δ₯΅Α½ΙΡ…ΉΠ°‰ΥЁΉ½Π…±έ…έΑ½ΝΝ₯‰±”Έ)±Ρ‘½Υ °₯Ё₯́չ±₯­•±δΡΌ‘…Ω”₯΅Α…Ρ•Ρ‘”½Υэ½΅”)₯ΈΡ‘₯́…Ν”°„™•ά½Ή•ΙΉΜ…‰½ΥЁё”Ή•½Ή…Ρ…°΅…Ή…”΄)΅•ΉΠέ•Ι”Ή½Ρ•θ+Šˆ€%Ё‘½•ΜΉ½Π…ΑΑ•…ȁё…Ёё•Ι”έ•Ι”…ΡΡ•΅ΑΡ́Ѽ‘…Ω”)„ΕΥ…±₯™₯•Α•‘₯…ΡΙ₯₯…Έ½Θ½Ρ‘•Θ₯Ή‘₯Ω₯‘Υ…°Ν­₯±±•)₯ΈΉ•½Ή…Ρ…°Ι•ΝΥ͍₯Ρ…Ρ₯½Έ…ΡΡ•ΉΡ‘”‘•±₯Ω•Ι䁕ٕΈ)Ρ‘½Υ ₯Ё݅́…Έ•΅•Ι•Ήδ •Ν…Ι•…ΈΝ•Ρ₯½Έ)™½ΘΝΥΝΑ•Ρ•™•Ρ…°½΅ΑΙ½΅₯Ν”Έ́ΝΡ…Ρ•₯ΈΡ‘”)9•½Ή…Ρ…°I•ΝΥ͍₯Ρ…Ρ₯½ΈAΙ½Ι…΄€‘9I@€Ρ•αΡ‰½½¬°+Šq•Ω•Ι䁉₯ΙΡ Ν‘½Υ±‰”…ΡΡ•Ή‘•‰δ…Ё±•…ΝЁ½Ή”)Α•ΙΝ½ΈΝ­₯±±•₯ΈΉ•½Ή…Ρ…°Ι•ΝΥ͍₯Ρ…Ρ₯½Έέ‘½Ν”½Ή±δ)Ι•ΝΑ½ΉΝ₯‰₯±₯Ρδ₯́΅…Ή…•΅•ΉΠ½˜Ρ‘”Ή•έ‰½ΙΈ»Št+Šˆ€Q‘”…Ή•ΝΡ‘•Ρ₯ΝЁ݅́΅½‰₯±₯镐έ‘•Έ₯Ё݅́•Ω₯‘•ΉΠ)Ρ‘…Ёё”₯Ή™…ΉΠέ…́½΅ΑΙ½΅₯Ν•‰ΥЁё•δ‘…)Ν½΅”‘₯™™₯Υ±ΡδΑΙ½ΥΙ₯Ήœ…Έ…₯Ι݅丁Q‘”₯Ή™…ΉΣŠeΜ