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Re: Switching patients**41 plusFrom: D. Ashley Hill (dahmd@cfl.rr.com)Thu Aug 26 21:39:32 2004
At Thu, 26 Aug 2004, Len2976@aol.com wrote: > >The patient's physician has a policy of "no IOL" till 41 1/2-42 weeks. This >was Saturday evening and she had a reassuring FHR strip. She also had and >IOL scheduled by her own physician on Monday. I felt inducing her at 41 2/7 >was basicly stealing the patient (as well as the medicaid fee) from him. >Obviously if the strip had been non-reassuring, the situation would have been >different. > >Lenora Understandable. We see many similar patients because we take all "walk in" patients as part of our teaching responsibilities and cover several clinical faculty who don't take call every day. If I were to see a patient > 41 weeks with a favorable cervix I would review the pros and cons of staying versus leaving. FWIW, in my experience, almost all patients will opt to stay for induction rather than risk the small but potential chance for stillbirth or fetal compromise. By 40-41 weeks, our patients "want it out" and do not seem willing to risk a bad outcome just to have their favorite physician or midwife do the delivery. Best wishes, Ashley
-- D. Ashley Hill, MD Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, Florida
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