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Checking cervices at termFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Mon Feb 27 11:23:40 2006
I check because: 1. Many patients want me to/are used to it. If they don't want me to, I don't unless overdue. 2. Nice to know that they're vertex, although this is not perfect, and yes, midwives, the cervical exam is done in concert with Leopold's. 3. Nice to know what their "baseline" is when the primigravida calls after hours with few contractions. The one who was 3/90% might go to L and D; the long/closed one would be encouraged to wait longer. I am AMAZED at home many people kind so many reasons NOT to check a cervix. For instance, one of our CNMs saw someone with "a few Braxton-Hicks) at 30 weeks, who had been bleeding intermittently from a polyp. She also had a retroplacental bleed at 15 weeks. Long story short, she delivered a week later. Now, who knows if a cervical exam might have detected anything, but I submit that it MIGHT have helped, and would have been unlikely to have hurt her situation. Again, when in doubt, take a history, review the chart, and do the examination! Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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