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Re: OB: Fun and Games at 42w1d (long) From: Anna Meenan, MD (annam@uic.edu) Wed Oct 12 19:32:49 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Anna Meenan, MD: "Re: OB: Fun and Games at 42w1d (long)" Previous message: Myer S. Bornstein: "Re: Breast biopsy by the radiologist" In reply to: Richard Chudacoff, MD: "Re: OB: Fun and Games at 42w1d (long)" Next in thread: Joanne Bulley, MD: "Re: OB: Fun and Games at 42w1d (long)" Reply: Joanne Bulley, MD: "Re: OB: Fun and Games at 42w1d (long)" I agree. Unfortunately, I don't think it's possible in this country to achieve complete and perfect informed consent. The lawyers have made an art out of finding the one small item you forgot to mention in your list of potential disasters, and I have not been impressed that these sorts of patients are any more likely to take responsibility for their own decisions than anyone else. I used to do a lot more of this kind of stuff, but I found myself spending too much time documenting things, and I had the misfortune to encounter a couple of patients in a row who got downright hostile when things didn't go as planned, so I decided that personal responsibility just plain does not exist in this country anymore and gave it up. -- Anna Meenan, MD At Wed, 12 Oct 2005, Richard Chudacoff, MD wrote: > >I agree Gail, as long as they empower themselves not to sue if they >empowered themselves wrong > >-- >Richard Chudacoff, MD > > _____ > >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of >rmodugno@aol.com >Sent: Wednesday, October 12, 2005 3:14 PM >To: Multiple recipients of list OB-GYN-L >Subject: Re: OB: Fun and Games at 42w1d (long) > >Gail - there is no medical literature I know that would support a gravida >going "well over 42 weeks", yet alone 44 weeks.As far as them "all having >good outcomes'' your series is in contra- distinction to the world >literature that states that after 42 weeks there is a rise in perinatal >morbidity/mortality. At our institution - delivering 17000+ per annum and >delivering them after 41 weeks we have seen a dramatic decrease in severe >asphixia and meconium aspiration - personal communication from the head of >neonatology. > >I would hardly call a woman who has had a previous cesarean with >pre-eclampsia, transverse lie, at 42 weeks (Garry's example) who does not >recognize that this is a problem "empowered" - indeed I would have another >adjective for her. > >Robert Modugno MD MBA FACOG >Marietta, GA > >-----Original Message----- >From: GA12L@aol.com >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >Sent: Wed, 12 Oct 2005 13:15:45 -0500 >Subject: Re: OB: Fun and Games at 42w1d (long) > >In a message dated 12/10/2005 18:41:46 GMT Standard Time, rmodugno@aol.com >writes: > >My thoughts: > >1) New adage: Nothing good happens after 41 weeks. >2) No one EVER tells a general surgeon how to do an appy or a gall-bag. >3) The inmates are running the asylum. > >Geez, you'd have a fit over her in the UK. Women who employ an independent >midwife and some who have their care under the NHS often refuse induction >and go well over 42 weeks. I know of several who have gone 43 + and one who >went 44 + 1. All with good outcomes. > >I don't know about the inmates running the asylum but I do know plenty of >empowered women. Personally, I prefer the more empowered woman. > >Gail > Next message: Anna Meenan, MD: "Re: OB: Fun and Games at 42w1d (long)" Previous message: Myer S. Bornstein: "Re: Breast biopsy by the radiologist" In reply to: Richard Chudacoff, MD: "Re: OB: Fun and Games at 42w1d (long)" Next in thread: Joanne Bulley, MD: "Re: OB: Fun and Games at 42w1d (long)" Reply: Joanne Bulley, MD: "Re: OB: Fun and Games at 42w1d (long)"

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