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Re: active tracing with decellFrom: Henry Gregor (henrygregor@yahoo.com)Wed Dec 19 09:29:22 2007
Well said, Ron. Louanna, I don't know how it goes with your patients. Ones I've seen over several thousand deliveries generally accept and acknowledge birth is a natural event with some occasional adverse events...I just haven't seen too many - either mine, or colleagues - who are that accepting of natural events, ex post facto a bad outcome that could have, maybe, just might have, possibly, been preventable by some intervention, even if that intervention led to some difficult neonatal circumstances. That said, the operant process here, is, I believe, an informed patient who is the major player in consenting to management processes...all documented in spades, of course. I think most patients go to obstetricians seeking care to enhance the potential for good outcomes, and minimize the potential for bad outcomes, even if those bad outcomes are low in potential occurence, so it is incumbent upon us to provide realistic assessments. (In fact, even if our counseling the patients leads to concerns by other providers that we might just be a bunch of curmudgeons casting every pregnancy as a disaster waiting to happen.)......Otherwise, they could deliver babies in a relaxed atmosphere at home, as my grandmothers did with nine children....though their choices were dictated by circumstance, not by their individual volition. :-) Hank ainsron <ainsron@sbcglobal.net> wrote: “You pays your money and you takes your chances.” Personally, if I have any doubt, I would rather have a sick, stable premie in the nursery than a potentially dead baby in the womb and most patients I take care of would rather have the same. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of westsidebirthservice@juno.com Sent: Wednesday, December 19, 2007 6:50 AM To: Multiple recipients of list OB-GYN-L Subject: Re: active tracing with decell Could be true knot that isn't fatal. Your'e going to deliver "just in case?" Just wondering where the dividing line is between the "every birth is a disaster waiting to happen and can't be diagnosed as normal until after the event" and "birth is a natural event with some fatal outcomes due to (someties cord) accidents." And what of the sequela of delivering a preterm baby because of the fear of a fatal cord accident? Louana -- Joe <forcep@intercom.net> wrote: Excellent point, Dan. Could have true knot which could be fatal. Joe C
R. Daniel Braun wrote:
> That makes no sense at all. If you have cord entanglement theoretically
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