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Re: Prolapsed cord From: art fougner, md (evsono@pipeline.com) Thu Feb 23 09:22:25 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Cheri Van Hoover: "Re: 2/06 ACOG Statement on 'Lay' Midwifery" Previous message: doctorjoe@aol.com: "Re: FRI 2/06 ACOG Statement on 'Lay' Midwifery" In reply to: Len2976@aol.com: "Re: Prolapsed cord" Next in thread: Efrain Ramirez: "Re: Prolapsed cord" Reply: Efrain Ramirez: "Re: Prolapsed cord" Reply: Garry E. Siegel, M.D.: "Re: Prolapsed cord" Thank the radiologist very much for reporting a finding that sounds horrendous and for which there is NO management plan. Most likely this will not result in real cord accident. This finding is akin to nuchal cord at same gestational age. Of course that's just my opinion. I could be wrong. Art At Thu, 23 Feb 2006, Len2976@aol.com wrote: > >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 -- art fougner, md Support Free Speech Buy Danish! Next message: Cheri Van Hoover: "Re: 2/06 ACOG Statement on 'Lay' Midwifery" Previous message: doctorjoe@aol.com: "Re: FRI 2/06 ACOG Statement on 'Lay' Midwifery" In reply to: Len2976@aol.com: "Re: Prolapsed cord" Next in thread: Efrain Ramirez: "Re: Prolapsed cord" Reply: Efrain Ramirez: "Re: Prolapsed cord" Reply: Garry E. Siegel, M.D.: "Re: Prolapsed cord"

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