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Re: suspected macrosomia outcome ? From: Braun, R. Daniel (rbraun@iupui.edu) Tue Mar 9 04:24:00 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Braun, R. Daniel: "Re: OB: this ever happened to you before?" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: suspected macrosomia outcome ?" Maybe in reply to: freda: "suspected macrosomia outcome ?" Next in thread: Garry E. Siegel, M.D.: "Re: suspected macrosomia outcome ?" Reply: Garry E. Siegel, M.D.: "Re: suspected macrosomia outcome ?" Why did she refuse? This is the crux of the situation. Dan "Sound is like water. If you drill one hole in the wall the sound will leak right through." - JAY BRAUN, a band member by love, a soundproofer by necessity. -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Monday, March 08, 2004 9:42 PM To: Multiple recipients of list OB-GYN-L Subject: Re: suspected macrosomia outcome ? Art: Certainly, in terms of outcome, it is a win-win, and I think that we all knew in our hearts that she would labor and eventually arrest. It is NOT a win for my practice, frankly. I think that when my partners or I advise a section in such a circumstance (and how uncommon is this--pretty uncommon), and it is refused, that we are left potentially hanging out to dry should the outcome be less than ideal. I do not enjoy practicing when patients refuse reasonable intervention presented in a reasonable fashion. I'm all for two was discussion and all, but, let's face it, this baby was at significant risk of birth injury and the mother refused to allow an appropriate section. Furthermore, she put herself and her baby at increased risk (albeit not much) by insisting on laboring. Garry At Mon, 8 Mar 2004, art fougner, md wrote: > >Healthy Mom? Healthy Infant? Looks like win - win here. > >art > >At Mon, 8 Mar 2004, ainsron wrote: >> >>I would have done it the same way. >> >>Ronald E. Ainsworth >> >>-----Original Message----- >>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of >>Garry E. Siegel, M.D. >>Sent: Saturday, March 06, 2004 8:51 PM >>To: Multiple recipients of list OB-GYN-L >>Subject: Re: suspected macrosomia outcome ? >> >>Betsy: >> >>One of my partners managed her labor and section. Remember, this is a >>patient that our practice had advised to have a scheduled section a >>week earlier, and she had refused. We had decided as a group that if >>she labored and progressed, so be it, but we would not induce or >>augment labor. >> >>What would others have done? >> >>Garry >> >>At Sat, 6 Mar 2004, Betsy Hyde wrote: >>> >>>On Saturday, March 6, 2004, at 06:33 PM, Garry E. Siegel, M.D. wrote: >>> >>>> But of course--while laboring, not just for the section. >>>> >>>I'm curious why she didn't get any pitocin? I certainly would not >>>have chased after a dysfunctional labor pattern with a macrosomic >>>fetus, but it's been my experience that women with epidurals often >>>have inadequate labor without pit. >>> >>>What were her contractions like? Did she not get pit because she >>>didn't need it, or because of other reasons? >>> >>>-- >>>Betsy Hyde CNM >>>Branford,CT >>> >>-- >>Garry E. Siegel, M.D. >>Private Practice >>Roswell, GA >> >-- >art fougner, md >ich bin ein New Yorker > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Braun, R. Daniel: "Re: OB: this ever happened to you before?" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: suspected macrosomia outcome ?" Maybe in reply to: freda: "suspected macrosomia outcome ?" Next in thread: Garry E. Siegel, M.D.: "Re: suspected macrosomia outcome ?" Reply: Garry E. Siegel, M.D.: "Re: suspected macrosomia outcome ?"

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