Re: Interesting case: Twins, 19 weeks, PPROM,etc.
From: Charlie Chambers (cchamber@gorge.net)
Wed Mar 16 20:30:48 2005
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Nice work, Brian. See, you didn't need a tertiary care center.
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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.
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On Mar 16, 2005, at 7:12 PM, Anna Meenan, MD wrote:
> Good job! Keep us posted on progress.
>
> Anna Meenan, MD
>
> At Wed, 16 Mar 2005, Brian Fox wrote:
>>
>> Now for the rest of the story. And so many people think nothing much
>> happens out in the boondocks.
>>
>> The patient felt something in the vagina about 36 hours after
>> admission; this proved to be a solitary fetal leg. Still no evidence
>> of
>> infection; she was advised the loss of the leading twin was now
>> inevitable, and
>> loss of the 2nd was likely; she was having a few mild cramps. Over the
>> course of the next 10 hours she reported some additional mild
>> cramping; some additional sensations in the vagina that proved to be
>> due to
>> successive delivery of the other leg, then the torso, and, finally,
>> the
>> head. Fetus was stillborn. Cord was tied off just inside of the cervix
>> with an Endoloop, and cut. The cervix then proceeded to close down.
>> Remaining twin was active and viable. She was watched in the hospital
>> overnight. Next morning, no cramps, no unusual discharge, Cervix
>> visualized and seen to be closed.
>>
>> Seen in office Monday; no fever, no cramps, no unusual vaginal
>> discharge. Cervix closed. Fetus B is active, strong and regular fetal
>> heart tones. Advised to rest often; to place nothing in the vagina;
>> take temperature twice/day; call if any feelings of ill health, etc.
>> To be seen twice/week and PRN. She continues to smoke and indulge
>> in her other
>> usual habits. I told her that today she is a walking miracle, but
>> could not provide any promise about the future.
>>
>> PS. Cowboy poetry festival is every year, last week of January; quite
>> a gathering.
>>
>> --
>> Brian W. Fox, MD, FACOG, Ruby Mountain OB-GYN
>> 1995 Errecart Blvd., Suite 103
>> Elko, NV 89801
>>
>
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