Re: Gestational pruritus in 3rd trimester and intrauterine fetal death
From: art fougner, md (evsono@pipeline.com)
Fri Aug 5 06:51:35 2005
Cholestyramine resin may be useful in this situation.
art
At Thu, 04 Aug 2005, Robert J. Carpenter, Jr. MD wrote:
>
>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
>
--
art fougner, md
"If you don't know where you are going, you will wind up somewhere else."
Lawrence Peter Berra
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