Re: Input appreciated
From: Robert J. Carpenter, Jr. MD, JD (zygote@icsi.net)
Wed Nov 14 22:11:58 2007
In the patient's best interest, assuming dx of IPCKD correct, termination should be
done, and she should use medical resources and take increased risks with a good
pregnancy.
She should not be transferred to MFM since we have nothing to offer that primary MD
and hospital can not. She is the master of her own fate.
RJC
On 14 Nov 2007 at 16:56, Richard Chudacoff wrote:
>
> Transfer care to MFM
>
> Richard Chudacoff, MD, FACOG
> Las Vegas International Center for Advanced Gynecologic Care
> (Specializing in minimally and non-invasive surgery)
> 2481 Professional Court
> Las Vegas, NV 89128
> TEL: 702-485-8893
> FAX: 702-974-0945
>
> http://www.lasvegasgyncenter.com
> http://www.exablateoflasvegas.com
>
> The information in this e-mail may be confidential and/or privileged. If you are not the
intended
> recipient or an authorized representative of the intended recipient, you are hereby
notified that any
> review, dissemination or copying of this e-mail and its attachments, if any, or the
information
> contained herein is prohibited. If you have received the e-mail in error, please
immediately notify
> the sender by return e-mail or phone and delete this e-mail. Thank you.
>
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
> JSBowpat@aol.com
> Sent: Wednesday, November 14, 2007 2:44 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: Input appreciated
>
> Your collective comments would be appreciated:
>
> ·23 yo G3P2 with ITP at 23.2 wks, platelets being done every month, stable b/w
> 60-70K - pt wishes to avoid steroids this pregnancy - her heme/onc gets the
> monthly results, with recommendations for ITP management - so far, just wait
> and see
> ·on 21 wk scan, marginal placenta previa
> ·sent forMFM consult this pregnancy, secondary to ITP - MFM knows pt from
> previous pregnancy
> ·MFM calls yesterday - dx'd fetus with infantile polycystic kidney disease "classic
> on U/S" were her comments
> ·AFI 3.0, on scan 2 wks ago 8.0
> ·pt not likely to terminate
> ·future genetic concerns? MFM stated this was an autosomal recessive d/o
> ·pt was told up front (prior to U/S findings) that should platelets get too low or
> marginal placenta previa remain, she is not appropriate for delivery at our Level 1
> community hospital
> Any recommendations?
>
> Susan Paterson CNM
>
> Judith Bowers DO
>
--
Robert J. Carpenter, Jr. MD, JD
6624 Fannin, #2720
Houston, TX 77030
(O) 713-795-4600
(F) 713-795-4422
"Life is difficult"
The Road Less Travelled
by Scott Peck
