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Re: Elective Induction - something goes wrongFrom: Braun, R. Daniel (rbraun@iupui.edu)Fri Jul 9 06:50:25 2004
A word of caution about Dubowitz scoring: The full Dubowitz including the neurological scale, which can't be done until 24 hours after delivery, has an accuracy of "PLUS OR MINUS 2 WEEKS". That is according to Dubowitz and Dubowitz in the article describing the score. So the Dubowitz score is no more accurate than the LMP. A 6 to 10 week US is accurate to plus or minus 5 days. That is much more accurate than a Dubowitz. 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 Vicki Smith Sent: Thursday, July 08, 2004 6:39 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Elective Induction - something goes wrong I have another point of view and question. I am a CNM that works with one OB-GYN. We work in a small rural hospital with about 25-30 deliveries a month. He will induce most women after 38 weeks if she whines at him long enough. When he schedules these inductions, a lot of them end up on my call days. (We have every other day/every other weekend call) He usually can make up a reason for induction, but sometimes he will say it is social. I am not a fan of inductions and we end up with a 30% C/S rate because of FTP. I finally talked him into trying 2 or 3 day inductions with rest from pit at night- if I can keep him from AROMing them early. Can you help me with lit that might convince him that this may not be the best plan of care or do I just shut up and go along with him? I really like working with him, but sometimes it goes against my grain to have to induce someone with a very low bishop score. I ended up with 38 weeker by dates that when delivered dubowitzed at about 35 weeks.Apgars of 6 and 8. PPV for about 30 sec. TTN and oxyhood for 12 hours while I held my breathe because the FP doc didn't want to transfer him. The CNM and OB/GYN in the next town over (about 30 miles) never induce pts and so we get some pts from them that want to pick a date. Any suggestions? Vicki Smith dellview@earthlink.net Midwives- Changing the world one baby at a time.
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