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Re: Severe PIH 34 weeks From: Andrew Folley (agfolley@hotmail.com) Thu May 24 07:38:24 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: R. Daniel Braun: "Re: Severe PIH 34 weeks" Previous message: Joe: "Re: Severe PIH 34 weeks" In reply to: DoctorJoe@aol.com: "Re: Severe PIH 34 weeks" We are dealing with a baby that is not IUGR but LGA. Preeclampsia is a subset of PIH. PIH is NOT a subset of Preeclampsia. These are facts. There is NO increased perinatal mortality due to PIH in normal size infants or LGA infants at least according to most recent study J. reporductive medicine out of Tulane Unviversity May 2007. "God does not play dice with the unviverse" Einstein. "Nor does he play rocks scissors paper" corrolary agf >From: DoctorJoe@aol.com >Reply-To: ob-gyn-l@obgyn.net >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >Subject: Re: Severe PIH 34 weeks >Date: Wed, 23 May 2007 13:18:57 -0500 > >In a message dated 5/23/2007 1:08:17 P.M. Central Daylight Time, >AllanHo@aol.com writes: > >The flip side of this argument is that if you deliver the baby, say by >c/s, >and the mother died from a PE. Now the burden of proof would be on why >the >baby had to be delivered so urgently... Because you "think" something bad >is >going to happen? > >No, you document what you did and why you did what you did. > >In this case, a "well grown" baby implies, at least to me, the hypertension >is due to preeclampsia. The treatment is delivery. We don't "think" the >treatment is delivery -- it is obstetric dogma that the treatment is >delivery. > >If, for the sake of argument, we posit that the HBP is due to chronic >hypertension, then that carries a WORSE prognosis as far as abruption and >sudden >fetal death, since there is chronic small vessel disease, yada, yada, yada. >(It >doesn't look like that here, since there is no IUGR, oligo, etc., but for >the > sake of argument ... .) So we don't "think" she needs to be delivered, >we >know that the stats on severe hypertensives in pregnancy are bad and there >is >a higher chance of something bad happening from the HBP than, say, a PE >postoperatively. > >All of that goes on the chart, is discussed with the patient, and you do a >C/S. If you do it NOW, you'll likely have less maternal morbidity than if >you >let her "declare" herself. > >Joe P. > _________________________________________________________________ PC Magazine’s 2007 editors’ choice for best Web mail—award-winning Windows _________________________________________________________________ Live Hotmail. http://imagine-windowslive.com/hotmail/?locale=en-us&ocid=TXT_TAGHM_migration_HM_mini_pcmag_0507 Next message: R. Daniel Braun: "Re: Severe PIH 34 weeks" Previous message: Joe: "Re: Severe PIH 34 weeks" In reply to: DoctorJoe@aol.com: "Re: Severe PIH 34 weeks"

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