|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: Prolapsed cordFrom: Len2976@aol.comThu Feb 23 06:15:19 2006
Our patient is a 23 y/o G3, P2002 at 22 1/2 weeks. Yesterday we recieved a handwritten preliminary faxed U/S report: "Viable IUP at 22-23 weeks FHTs 153 Cephalic presentation Possible cord prolapse into cervical os." The patient's first 2 pregnancies were uneventful. This pregnancy has been significant for 1st trimester bleeding attributed to a LLP on U/S. Recently she has noted intermittant spotting and cramping. When I showed the report to the obstetrician (1 OB, 3 CNM practice) his immediate thought was that she had had a SROM, while I wondered about a placenta previa or an incompetant cervix. I called the patient in to L&D and spoke to the radiologist to get more information. He said there was no previa, a normal AFI, a cervical length of > 4 cms. Our U/S department may not always identify small abruptions or subchorionic bleeds. The radiologist said he was quite sure about the prolapsing cord as they had visualized it using dopplar. The patient was (currently) experiencing no bleeding or cramping and her cervix was LTC. Our present management was to observe her overnight and repeat the U/S today. If the results are the same--??? The obstetrician suggested a perinatal consult. I know from past experience that the local high risk facility will not take a facility to facility transfer at 22-23 weeks as they consider it pre-viable. The other option would be to make her an appt. (likely next week) in the high risk clinic. We would appreciate any other thoughts or suggestions. Lenora McCall, CNM Spring Hill, Fl
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Thu Oct 2 04:52:05 2008 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.