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Re: Gestational pruritus in 3rd trimester and intrauterine fetal death From: Robert J. Carpenter, Jr. MD (zygote@icsi.net) Thu Aug 4 22:09:54 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Robert J. Carpenter, Jr. MD: "Re: Interesting question" Previous message: R. Daniel Braun: "Re: Gestational pruritus in 3rd trimester and intrauterine fetal death" In reply to: R. Daniel Braun: "Re: Gestational pruritus in 3rd trimester and intrauterine fetal death" Next in thread: art fougner, md: "Re: Gestational pruritus in 3rd trimester and intrauterine fetal death" Reply: art fougner, md: "Re: Gestational pruritus in 3rd trimester and intrauterine fetal death" The data concerning cholestasis and pruritis gravidarum is a complex bag. The original separation was the presence of pruritis only without abnormality of lifer funcrttions tests (LFT). That has a low probability of IUFD but it does occur. The real question is what degree compared to the background of normal patients. With elevated LFT then the IUFD rate increases and surveillance is indicated. The Europeans use an agent but name not in head at this moment. Best recall study about 24 months ago from either Sweden or Norway. Go to PubMed and search will pull up the article. I use fetal mvement counts as per the method of Eliah Sadovsky as my prime surveillance tool. Mom counts for 30 mninutes TID at same time of day and about 90-120 minutes post meal. After 4 days of counts the average is taken and that is the "truth" If there is a decrease by 50% on 2 consecutive counts then other testing usually CST is done. Mom's appreciation of movem,ent is your best index of well being. If severe pruritis is present at 30 weeks then some surveillance is indicated as Dan indicated. On 4 Aug 2005 at 21:27, R. Daniel Braun wrote: > There are other papers back before that one which say the same thing. > We start fetal surveillane at 30 weeks and deliver at 35 weeks in our > patients with Chlestasis of pregnancy. Dan > > On 8/4/05, Ricardo Savaris <rsavaris@hcpa.ufrgs.br> wrote: > > > > Dear all, > > > > I am a little bit away from the obstetrics front , but I received an > > information about the gestational pruritus in 3rd trimester and > > intrauterine fetal demise. What I found was a series of cases (BJOG, > > 2004,Jul;111(7):676-81.) and I don't have access. Nevertheless, it > > doesn't seem to a good evidence. If you give me some literature to > > read would be interesting, but your personal experience would be > > even better. > > > > Ricardo Savaris > > > > -- > R. Daniel Braun > Kinky for Governor > -- Robert J. Carpenter, Jr. MD 6624 Fannin, #2720 St. Luke's Medical Tower Houston,TX 77030-2339 713-795-4600 Next message: Robert J. Carpenter, Jr. MD: "Re: Interesting question" Previous message: R. Daniel Braun: "Re: Gestational pruritus in 3rd trimester and intrauterine fetal death" In reply to: R. Daniel Braun: "Re: Gestational pruritus in 3rd trimester and intrauterine fetal death" Next in thread: art fougner, md: "Re: Gestational pruritus in 3rd trimester and intrauterine fetal death" Reply: art fougner, md: "Re: Gestational pruritus in 3rd trimester and intrauterine fetal death"

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