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Re: Difficult caseFrom: Andrew Folley (agfolley@hotmail.com)Mon May 14 18:39:08 2007
26 yo WF G3P2 at 26 weeks presents to triage last friday evening with bleeding. No prenatal care. This is her third pregnancy with 8 pound baby delivered vaginally 6 years ago and 5 pound baby delivered at 36 weeks c-section for breech 15 months ago. Ultrasound on admission shows low lying placenta possible marginal previa and some possibility of abruption. US also reveals oligohydramnios with AFI 3 cm. Ultrasound plots the infant at 27 weeks 5 days. Weight is 2 poiunds, vertex and 47% for growth; no anomalies seen. She receives steroids Friday and Saturday. FHTs are 140s and "normal non reactive for 26 weeker" no variables seen. Patient remains stable Sunday and today bleeding about one pad per day and no pain or contractions. Continuous EFM show no changes in tracing. MFM consultant recommends she be delivered soon ie next 24 hours by C-section. Why???? _________________________________________________________________ Make every IM count. Download Messenger and join the i’m Initiative now. -- _________________________________________________________________ It’s free. http://im.live.com/messenger/im/home/?source=TAGHM_MAY07
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