Re: 41 week Induction

From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Sun Dec 4 08:17:50 2005


Ef hits the nail on the head.

It is with trepidation that I send home the young primigravida at, say 40w3d, who has been "contracting" for hours, maybe a day, but really isn't clearly in labor (i.e. 3 to 4 cm. and effaced with regular contractions).

Many times, the patient/husband/mother deliver a tremendous amount of direct and implied pressure.

Every blue moon, something goes wrong. . .and perhaps things would have been better had you simply kept her and induced her.

Garry

At Sun, 4 Dec 2005, Efrain Ramirez wrote: >
>One of the reasons, besides convenience (for the doctor and the
>patient), is fear of litigation. When a patient is on her 40th week a
>typical conversation with the patient AND her mother AND her mother in
>law would bring up the bad outcomes they have heard because of “waiting
>to long” – “fue un parto seco” – it was a “dry labor” - almost no
>stories on “bad” outcomes with inductions -- after a lot of explaining –
>one more week is accepted – after that… and specially in a multip. –
>and with the available data – the question is …why NOT go ahead and
>induce? – In the people’s mind – keep on waiting is “doing nothing” –
>--inducing one is "trying to avoid bad consequences" – in the event of
>an emergency C/S due to “failed induction”, failure to progress or
>“intolerance to labor” – the Doc did everything he could … that’s the
>way it is – at least down here….
>
>Ef
>
>At Sun, 04 Dec 2005, Dr Eberhard Lisse wrote:
>>
>>Efrain Ramirez wrote:
>>> 41 weeks to me is 40 completed weeks - not 40 + 1 day ..
>>
>>40 + 1 is 40 completed weeks plus one day = 41 weeks.
>>
>>> 41 weeks is a reasonable gestational age for induction - (one can wait
>>> 2-3 more days on a primip with good BPP) - with adequate dates and/or
>>> ultrasound..
>>
>>Why is is that roughly 100% of patients walking into some hospitals in
>>the US are induced with no discernible imprevement in outcome?
>>
>>el
>
>--
>Ability is what you're capable of doing.
>Motivation determines what you do.
>Attitude determines how well you do it.
>
> - Lou Holtz
>
> ~walt whitman~
>

--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA




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