The other possibility which I recollect having seen but do not recollect
the name for is that for some women for whom flexion of the knee is not
possible, then if lithotomy was really needed, their legs could be
supported straight instead of flexed in the lithotomy position. Emphasis
here would be on being "supported" in the position.
Kathy CL
> Debra,
>
> I understood that extended lithotomy was comparable to the 'McRobert's
> manoeuvre used to address shoulder dystocia -- a hyperflexion of the hip
> joints so that the knees are against the mother's chest at the level of
> her
> arm pits. This position is most commonly used to facilitate delivery of
> the
> anterior fetal shoulder. As you can see from the picture below, the inlet
> and outlet of the pelvis come into vertical alignment creating additional
> space for the babe to slip out under the pubic bone, or for the care
> provider
> to reach in to the woman's vagina to rotate the baby's anterior shoulder
> from
> behind the pubic bone or alternately extract the posterior arm.
>
>
>
>
> <http://www.p-b-parese.dk/BrachialPlexusPalsy/images/mcroberts_position.gif>
>
>
> image from Gabbe, Niebyl, and Simpson, Obstetrics: Normal and Problem
> Pregnancies, Churchill Livingstone, New York, 1986
>
> Anne
>
> Anne L. Maranta, BIS (Midwifery), BA
>
> Associate Project Manager
>
> Multidisciplinary Collaborative Primary Maternity Care Project
>
> 780 promenade Echo Drive, Ottawa, ON, K1S 5R7 (Canada)
>
> T: 1-800-561-2416 or (613) 730-4192 ext. 261
>
> F: (613) 730-4314
>
> E: [log in to unmask]
>
> Website: www.mcp2.ca <http://www.mcp2.ca/>
>
>
>
> -----Original Message-----
> From: A forum for discussion on midwifery and reproductive health
> research. [mailto:[log in to unmask]] On Behalf Of Debra
> Kroll
> Sent: Sunday, March 12, 2006 7:16 PM
> To: [log in to unmask]
> Subject: extended lithotomy position
>
>
>
> Does anyone know what midwives meant when they refered to "extended
> lithotomy"?
>
> My recall is that instead of using lithotomy poles in the second
> stage of labour when women were though not to be pushing well midwives
> used
> to support women's legs either on their hips or with their hands.
> Something
> midwives often did on LW (before they realised how bad it was for their
> backs). Anyone have a different view or recall??
>
> Debra Kroll
> Midwifery Lecturer in Practice
>
>
>
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