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Cervical lengthFrom: Henry Gregor (henrygregor@yahoo.com)Mon Feb 6 21:36:14 2006
Fellow listers, What thoughts have you on sonographic cervical lenght assessments? I've been to courses and have read pubs wherein some "gurus" dicscuss the utility of such measurements in managing PTL or at risk for PTL patients. Others have downplayed their usefulness...most impressively done on a few occasions with photos of patients exhibiting significantly changing cervical lenghts when followed serially over time, be it one or two hours or one or two days. The one thing the speakers seemed to have uniformly in common, was a pattern of being on the speakers' lists at some pretty posh locations, in hotels with pretty obscenely priced "special conference rates", lol. Hank "S Osterling M.D." <sdoesterling-obgyndotnet@yahoo.com> wrote: It's always hard to manage the preterm labor patient. The diagnosis has gotten blurry with fetal fibronectin and cervical ultrasound. Just wait until proteomics hits clinical practice! Its also very easy to play Monday morning quarterback with these ladies. After that disclaimer- The patient has a 1.5 cm cervix that is closed and a +FFN in a preterm case. No previous pregnancy history to guide us. I will also assume no documented cervical change. I would have to go on contractions. I would give her mag sulfate (being careful not to use any unapproved abbreviations) until she has completed her course of steriods. I'd wean her to nothing after that and carefully try to correlate her reported contraction with any cervical change. If I can document contractions on the toco and she can feel them, I'd try oral nifedipine 20 mg q 6 and bump to q 4 as needed. 48 hrs of indocin may also help. I'd try to send her home two days after her mag was turned off. I usually tell my PTL patients that if everything goes perfectly, they'll be in house for 5 days - longer if they don't respond. If I send them home, they go on bed rest with bathroom privileges until 34 weeks. On Feb 6, 2006, at 8:00 PM, Efrain Ramirez wrote:
> No dilation - soft, anterior.... S. Osterling M.D. California
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