Re: Oligohydramnios
From: Jefferson Delfino (dr.jefferson@uol.com.br)
Wed Nov 7 12:50:53 2007
Do you use to do US+Doppler?
Jefferson
---------- Início da mensagem original -----------
De: ob-gyn-l@obgyn.net
Para: "Multiple recipients of list OB-GYN-L" ob-gyn-l@dns.obgyn.net
Cc:
Data: Tue, 6 Nov 2007 20:14:09 -0600
Assunto: 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
>
