Re: 34 week prom
From: art fougner, md (evsono@pipeline.com)
Fri Apr 8 08:09:14 2005
Dan ...
in this setting, without digital exams ... please define labor.
Art
At Fri, 8 Apr 2005, R. Daniel Braun wrote:
>
>I would manage by doing
>
>1. NO digital vaginal exams,
>2. Ampicillin
>3. Steroids
>4. Observation IN HOSPITAL until:
> A. Reaches 37 weeks or
> B. Shows signs of infection.
>
>My observation in addition to Temperature recording would include a
>daily 10 min FHR strip for BASELINE FHR. The baseline FHR will
>increase prior to most other signs of infection. Would also daily
>palpate for tenderness. Labor in a patient with ROM may well be a sign
>of infection and hence an indication for delivery.
>
>Dan
>
>On Apr 7, 2005 7:58 PM, Robert J. Carpenter, Jr. MD <zygote@icsi.net> wrote:
>> Not if I have my say and nature is cooperative with no labor, no infection, etc.
>>
>> On 7 Apr 2005 at 12:20, Richard Chudacoff, MD wrote:
>>
>> > What did the MFMs want you to do? In one of my intuitions they want
>> > them delivered at 34 weeks
>> >
>> > Richard Chudacoff, MD
>> >
>> > -----Original Message-----
>> > From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>> > Andrew Folley Sent: Thursday, April 07, 2005 11:16 AM To: Multiple
>> > recipients of list OB-GYN-L Subject: RE: 34 week prom
>> >
>> > Question: Had a patient show up last night G3P2 ruptured membranes 34
>> > weeks
>> >
>> > 1 day. 2 prior c-sections. Not in Labor. What to do? She is vertex
>> > fluid in vault sent for f-pole showed not mature. My plan was
>> > steroids, tocolysis
>> >
>> > for 48 hours if necessary and repeat c-section in 48 hours.
>> > Along with GBS prophylaxis. Some of our MFMs were not so happy with
>> > the management plan. What ywoud you do???? andy
>> >
>> > >
>> >
>> > _________________________________________________________________
>> >
>> > _________________________________________________________________
>>
>> Robert J. Carpenter, Jr. MD
>> 6624 Fannin, #2720
>> St. Luke's Medical Tower
>> Houston,TX 77030-2339
>> 713-795-4600
>>
>--
>R. Daniel Braun
> Kinky for Governor
>
--
art fougner, md
"If you don't know where you are going, you will wind up somewhere else."
Lawrence Peter Berra
