Re: Gestational pruritus in 3rd trimester and intrauterine fetal
From: art fougner, md (evsono@pipeline.com)
Mon Aug 8 07:52:20 2005
Peter
TY 10^6!
art
At Sun, 07 Aug 2005, Peter Wein wrote:
>
>Ursodeoxycholic acid much better - there has been RCT showing improved
>outcome in IHCP with urso, much better tolerated.
>
>--
>Peter Wein
>
>art fougner, md wrote:
>
>>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
>>
--
art fougner, md
"If you don't know where you are going, you will wind up somewhere else."
Lawrence Peter Berra
