Re: pprom and antibiotics
From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com)
Tue Aug 9 08:31:32 2005
Okay, but her fetal lung maturity test came back immature. Now what would
y'all do? Still afebrile, negative c-reactive protein, normal WBC,
non-tender and acontractile.
--
Richard Chudacoff, MD
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-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Efrain
Ramirez
Sent: Monday, August 08, 2005 6:46 PM
To: Multiple recipients of list OB-GYN-L
Subject: Re: pprom and antibiotics
Give her another anitibiotic - whatever - and deliver...
>At Mon, 8 Aug 2005, Garry E. Siegel, M.D. wrote:
>
>Agree with prompt delivery. If you had it to do all over again:
>
>1. Culture for GBS upon admission if no result known.
>2. Cover with PCN for GBS.
>3. Deliver since 35 or more.
>
>The gastroschisis doesn't alter management.
>
>My understanding is that the latency is increased with Amp/Erythromycin.
>That is not needed here.
>
>Now, if you're already on Amp/Erythromycin, and she can't tolerate the
>Erythromycin, dropall antibiotics since GBS negative and deliver.
>
>Garry
>
>At Mon, 8 Aug 2005, Charlie Chambers wrote:
>>
>>Not necessarily. I figure that at 36 weeks this kid has a low chance of
>>RDS. What's the odds of chorio with PPROM or cord accident in the next
>>week? Worst case scenario, I guess I'd rather have a kid with
>>gastroschisis and at worst mild RDS, vs. gastroschisis wtih chorio or
>>cord compromise.
>>
>>On Aug 8, 2005, at 11:23 AM, Richard Chudacoff, MD wrote:
>>
>>> Would fetal gastroschisis change your management with PPROM?
>>>
>>>
>>> Richard Chudacoff, MD
>>>
>>>
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>>>
>>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>>> rmodugno@aol.com
>>> Sent: Monday, August 08, 2005 1:17 PM
>>> To: Multiple recipients of list OB-GYN-L
>>> Subject: Re: pprom and antibiotics
>>>
>>> Not sure why you're not delivering this patient with pprom at 36
>>> weeks.
>>>
>>> Robert Modugno MD MBA FACOG
>>> Marietta, GA
>>>
>>>
>>>
>>> -----Original Message-----
>>> From: Richard Chudacoff, MD <rchudacoff@mylinuxisp.com>
>>> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>>> Sent: Mon, 8 Aug 2005 10:29:53 -0500
>>> Subject: pprom and antibiotics
>>>
>>> I have a question, which Bob Carpenter and I have discussed, but I
>>> wanted the groups opinion.
>>>
>>> 18 yo G1 at 35 weeks, PPROM. Started on Amp and Erythromycin
>>> prophylactically, but could not tolerate the Erythro, so this was
>>> stopped. GBS came back negative. Patient is now 36 weeks. My question
>>> is, in the face of data that shows in increase in resistance and
>>> necrotizing enterocolitis with ampicillin, Unasyn or Augmentin without
>>> erythromycin, would you continue the ampicillin? Now, let?s add the
>>> fact that the baby has gastroschisis?what would your antibiotic option
>>> be?
>>>
>>> Richard Chudacoff, MD, FACOG
>>>
>>> Women's Specialists of Houston
>>> 6624 Fannin Suite 1800
>>>
>>> Houston, TX, 77030
>>>
>>> 713-797-1144
>>> 713-425-3071
>>>
>>> Email: Richard.Chudacoff@obgyn.net
>>> rchudacoff.md@womenspecialists.com
>>>
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>>************************************************************************
>>****
>>************************************************************************
>>************************************************************************
>>
>>--
>>Charlie Chambers
>>Hood River, OR USA
>>cchamber@alumni.rice.edu
>>
>>"...not because I regard fishing as being so terribly
>>important but because I suspect that so many of the other
>>concerns of men are equally unimportant-and not nearly
>>so much fun."
>> John Voelker
>>************************************************************************
>>*****
>>************************************************************************
>>************************************************************************
>>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
--
"Character may be manifested in the great moments, but it is made in the
small ones."
- Phillip Brooks
~walt whitman~
