Re: Oligohydramnios
From: Richard Kaplan (rkaplan@triad.rr.com)
Tue Nov 6 21:35:49 2007
Gary,
You hurt me! Yes, a speculum exam was done and was negative for ROM.
RK
>----- Original Message -----
From: "Garry E. Siegel, M.D." <garrys@mindspring.com>
To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
Sent: Tuesday, November 06, 2007 9:14 PM
Subject: Re: Oligohydramnios
> And, FWIW, was a speculum exam done?
>
> Garry
>
> At Tue, 6 Nov 2007, ainsron wrote:
>>
>>Personally, I wouldn't unless there was other signs of fetal compromise.
>>If
>>she is obese, how reliable is your assessment of pocket size? I would do
>>weekly biophysical profiles, twice weekly Nests.
>>
>>Ronald E. Ainsworth, MD, FACOG
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Richard
>>Kaplan
>>Sent: Tuesday, November 06, 2007 4:55 PM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: Oligohydramnios
>>
>>Ron,
>> We have talked about this. She is obese and there is some concern
>> about
>>
>>being able to find a pocket. I believe that this should have been done as
>>soon as the question was raised about ROM last week. She has no fever,
>>leukocytosis, or tachycardia. If we did rule out ROM, would anyone induce
>>her at 34 weeks for unexplained, persistent oligo?
>>
>>Richard Kaplan, M.D.
>>
>>>>----- Original Message -----
>>From: "ainsron" <ainsron@sbcglobal.net>
>>To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
>>Sent: Tuesday, November 06, 2007 7:37 PM
>>Subject: Re: Oligohydramnios
>>
>>> If he really believes she has undiagnosed PROM, why doesn't he recommend
>>> amnio - check maturity and also place indigo carmine dye to definitely
>>> diagnose ROM? Any elevation of WBC or fever? Any tachycardia?
>>>
>>> Ronald E. Ainsworth, MD, FACOG
>>>
>>> -----Original Message-----
>>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>>> Richard
>>> Kaplan
>>> Sent: Tuesday, November 06, 2007 4:03 PM
>>> To: Multiple recipients of list OB-GYN-L
>>> Subject: Oligohydramnios
>>>
>>> 22 y.o. black female at 32-33 weeks has AFI(Aminiotic Fluid Index) of
>>> 2.5 on office ultrasound. Fetal growth at 50%ile, biophysical profile
>>> 6/8
>>> (decreased amniotic fluid), NST reactive. Admitted for course of
>>> steroids,
>>> IV hydration, and continuous fetal monitoring. MFM(Maternal Fetal
>>> Medicine)
>>>
>>> consultent repeats ultrasound after 48 hours and finds AFI of 5. He
>>> opines
>>> that there is occult PPROM (Preterm Premature Rupture of Membranes) and
>>> suggests antibiotics and delivery at 34 weeks. Pt. is scheduled for
>>> induction tomorrow (34 weeks). NST and BPP still normal, AFI stable at
>>> 5,
>>> and no evidence of ROM (other than decreased AFI).
>>> Is she being over treated?
>>>
>>> Richard Kaplan, MD
>>>
>
> --
> Garry E. Siegel, M.D.
> Private Practice
> Roswell, GA
>
