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Re: What would you do? From: Efrain Ramirez (eramirezt@coqui.net) Thu Dec 28 17:19:21 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Henry Gregor: "Re: Pagers (From Today's NY Times)" Previous message: Garry E. Siegel, M.D.: "Re: What would you do?" In reply to: Garry E. Siegel, M.D.: "Re: What would you do?" Next in thread: Bernard Cristalli: "Re: What would you do?" Reply: Bernard Cristalli: "Re: What would you do?" I agree with JoeP .. I would not do an amnio.. sticking a needle into the uterus on heparin with 36 weeks.. ? Bernard ..the risk of uterine rupture after 2 C/S is definitively greater.. CLINICAL MANAGEMENT GUIDELINES FOR OBSTETRICIAN—GYNECOLOGISTS NUMBER 54, JULY 2004 • (Replaces Practice Bulletin Number 5, July 1999) • What are contraindications for VBAC? A trial of labor is not recommended in patients at high risk for uterine rupture. Circumstances under which a trial of labor should not be attempted are as follows: • Previous classical or T-shaped incision or extensive transfundal uterine surgery • Previous uterine rupture • Medical or obstetric complication that precludes vaginal delivery • Inability to perform emergency cesarean delivery because of unavailable surgeon, anesthesia, sufficient staff, or facility • Two prior uterine scars and no vaginal deliveries Ef At Thu, 28 Dec 2006, Garry E. Siegel, M.D. wrote: > >It might not be so crazy to consider an amniocentesis for maturity (if >it looks easy to do), and if mature, reverse the anti-coagulation, and >deliver per Joe. > >Garry > >At Thu, 28 Dec 2006, Bernard Cristalli wrote: >> >>Then you seem to have your answer, but two previous CSs don't mean >>another CS if the indication for the previous ones isn't there any longer. >>BC >> >>Dr Eberhard Lisse a écrit : >>> 2 previous C/S... >>> >>> el >>> >>> on 12/28/06 4:03 PM Bernard Cristalli said the following: >>> >>>> Then let the pregnancy go its normal way and discuss the way of delivery >>>> on time. >>>> A vaginal delivery would expose to a lesser risk than a CS. Lesser risk >>>> of hemorrhage and lesser risk of thrombo-embolic accidents. >>>> IMHO >>>> BC >>>> >>>> Dr Eberhard Lisse a écrit : >>>> >>>>> And then do what? >>>>> >>>>> el >>>>> >>>>> on 12/28/06 12:36 PM Bernard Cristalli said the following: >>>>> >>>>>> Wait till the cardio-pulmonary situation is stable. >>>>>> >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > -- “ The greatest obstacle to knowledge is not ignorance, it is the illusion of knowledge.” Daniel J. Boorstin - Historian Next message: Henry Gregor: "Re: Pagers (From Today's NY Times)" Previous message: Garry E. Siegel, M.D.: "Re: What would you do?" In reply to: Garry E. Siegel, M.D.: "Re: What would you do?" Next in thread: Bernard Cristalli: "Re: What would you do?" Reply: Bernard Cristalli: "Re: What would you do?"

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