Re: active tracing with decell

From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com)
Thu Dec 20 06:16:53 2007


For me the solution is simple. I have a healthy baby now. I do not know, if she leaves L&D, that I will still have a healthy baby n 24-48 hr. So I believe only three options exist: deliver, continuous monitoring on L&D until delivery, transfer to MFM.

--
Richard Chudacoff, MD, FACOG
-sent from my Treo 650

-----Original Message-----

From: "Raymond Stephen" <Stephen.Raymond@dhhs.tas.gov.au> Subj: RE: active tracing with decell Date: Wed Dec 19, 2007 10:04 pm Size: 2K To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>

Compare the number of times you have seen a true knot at delivery of a well child and the number of cases of intrauterine death due to a true knot. Further, because of the turgidity of the cord due to its blood pressure there is room for doubt that cord accidents are the cause of death rather than the antecedent of death from other blood flow problems.

Steve

________________________________

From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of

--
________________________________
westsidebirthservice@juno.com
Sent: Thursday, 20 December 2007 1:50 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 > it could at any time become so severe that it kills the baby. So > logically you have to either monitor her continuously until delivery or > ignore it. NST's and CST's don't predict anything about cord problems,

> only about UPI. Therefore they are of no benefit. > > IMHO > Dan > > On Dec 18, 2007 8:05 PM, Raymond Stephen > <Stephen.Raymond@dhhs.tas.gov.au > <mailto:Stephen.Raymond@dhhs.tas.gov.au>> wrote: > > And, you're going to mess up her sugars. Ask yourself shy she had the > deceleration - can't be placental insufficiency, no IUGR, so it has to > be an intermittent cord compression,? entanglement, probably won't > happen again, why not just check CTG regularly? > > -----Original Message----- > From: ob-gyn-l@obgyn.net <mailto:ob-gyn-l@obgyn.net> > [mailto:ob-gyn-l@obgyn.net <mailto:ob-gyn-l@obgyn.net>] On Behalf Of > Richard Chudacoff > Sent: Wednesday, 19 December 2007 11:51 AM > To: Multiple recipients of list OB-GYN-L > Subject: RE: active tracing with decell > > That is true, especially in this case with GDM. But hey, that is why I > don't > deliver anymore > > Richard Chudacoff, MD, FACOG >

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