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IUFD ManagementFrom: RModugno@aol.comSun May 30 21:15:01 2004
Recently managed a patient for a colleague - was on call and he was out of town. Patient with an IUFD at 28 weeks diagnosed by his CNM. Immediately brought into the hospital for induction of labor. Given cytotec over 24 hours( 200 to 400 micrograms q4h without delivery). Patient and husband getting more and more upset about not delivering quickly.Then subsequently delivers in about 6 hours after one prostin e2 20mg suppository. My thoughts: Why the"rush" to immediately bring the patient into the hospital? These folks were given no time to let this tragedy sink in, to express their grief to family and friends, placed in an unfamiliar environment with strangers, with the expectations of "rapid delivery". In the so-called "bad old days", we allowed patients to go home, gather their thoughts, grieve with family and friends and then bring them in to the hospital to induce labor. I think this case is a symptom of our Mc Donald's Drive -Thru society, where people expect things to happen immediately, if not, some thing is "wrong", and they get upset, and not infrequently, it is the health care provider who is "blamed " for this. Any thoughts? Robert Modugno MD MBA FACOG Marietta, GA http://www.novaobgyn.yourmd.com
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