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Re: preterm ROM From: Charlie Chambers (cchamber@gorge.net) Wed Mar 10 23:53:06 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Steve & Eryl Raymond: "Re: cerclage question" Previous message: DoctorJoe@aol.com: "Re: OB: this ever happened to you before?" In reply to: GIN11153@aol.com: "Re: preterm ROM" Next in thread: laure: "Re: preterm ROM" Reply: laure: "Re: preterm ROM" Gail I think at this gestation where you clearly have viability, your taking too much of a risk to send this patient home. MAYBE an option in an early second trimester pregnancy that is previable. Also, serial white counts are not sensitive nor specific in this situation. BTW, the old yogurt and lactobacillus has no scientific basis. Vaginal flora does require lactobacillus but these are a type that essentially make hydrogen peroxide which the yogurt/acidophilus, and lactobacillus tablets do not. BTW, you are not "just a nurse". You have more in the trenches experience than quite a few of us. No substitute for experience. ************************************************************************ **** Charlie Chambers Hood River, OR cchamber@alumni.rice.edu "Almost anything you do will seem insignificant but it is very important that you do it....You must be the change you wish to see in the world" -- Mahatma Ghandi. ************************************************************************ ******* On Mar 10, 2004, at 1:00 PM, GIN11153@aol.com wrote: > Dr. Chudacoff, > > I realize I am 'just a nurse', but I have learned a lot being > certified in high risk OB for 10 years and working in the obstetrics > setting for 30 years. I have seen may patients in your situation who > did go home, if they were at -1 station and no higher to prevent cord > prolapse), with serial  white counts done, usually 3 times a week. Mom > is instructed to take her temp every 6 hours and record it, along with > kick counts . Half the patients have been on prophylactic > antibiotics(usually Keflex as Ampicillin can cause difficult to treat > monilia infections and diarrhea despite daily yoghurt and > lactobacillis tablets)-the other half are not on anything. Most also > have 2-3 times  a week NSTs done. > > I have not seen patients sent home on Terbutaline, I assume because > one would want to know if the uterus was becoming irritable  from > chorioamnionitis. > > Don't know why doctors' wives  have more complications-being a > doctor's wife myself I can say that it does seem to happen  quite a > lot. > > I hope your patient can keep her  'bun in the oven' as long as > possible. Good luck! > > Gail Neuman RNC CPHW SNP > Perinatal education > Perinatal Nurse Associates > Tustin, CA Next message: Steve & Eryl Raymond: "Re: cerclage question" Previous message: DoctorJoe@aol.com: "Re: OB: this ever happened to you before?" In reply to: GIN11153@aol.com: "Re: preterm ROM" Next in thread: laure: "Re: preterm ROM" Reply: laure: "Re: preterm ROM"

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