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Re: Care of pregnancy in a patient who has had a Whipples procedure. From: Raymond Stephen (Stephen.Raymond@dhhs.tas.gov.au) Mon Jan 14 08:35:16 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dean Huffman .: "Reproductive Health Specialist Jay Grodin, 67" Previous message: GIN11153@aol.com: "Screen all young women every year for Chlamydia, CDC urges" In reply to: Andrew Folley: "Re: Care of pregnancy in a patient who has had a Whipples procedure." Next in thread: Andrew Folley: "Re: Care of pregnancy in a patient who has had a Whipples procedure." Reply: Andrew Folley: "Re: Care of pregnancy in a patient who has had a Whipples procedure." If you control her postprandial blood sugars at 1 hour to less than 7.8 there will be very little chance that any complication will occur relating to her diabetes. If the baby should weigh >4500gm at 37 -38 weeks then you haven't done your job. Where is the evidence that a properly controlled diabetic needs delivery at 39 weeks? Tell me how the HbA1C helps in the management? Steve ________________________________ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Andrew -- ________________________________ Folley Sent: Monday, 14 January 2008 3:11 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Care of pregnancy in a patient who has had a Whipples procedure. 1. Do not need to do biophysical profiles weeksy. NST biweekly and afi with the NST is sufficient (equivocal to biophysical profile) 2. Deliver at 39 weeks if euglycemic 3. Vaginal birth unless obstetrical complications or 4. CS if weight >4500 grams at 37-38 weeks? 4. Watch serial growth with US for growth q 3 weeks 5. HbA1C > Date: Sun, 13 Jan 2008 05:46:12 -0600 > From: johnprov@sympatico.ca > To: ob-gyn-l@dns.obgyn.net > Subject: Care of pregnancy in a patient who has had a Whipples procedure. > > 31 y.o. G1 who had a Whipple's procedure at age of 26 for what turned > out to be a benign neuroendocrine tumor. She has done remarkably well > after her surgery and has essentially lead a normal life with no special > modifications in diet, life style or need of meds. I sent her off for > her glucose tolerance rest after her second visit at 19 weeks and the 1 > hr value was 14.7(14.7 X18 &4.6) (for those who still live with the > old units), with that value I sent her off to our local Endocrinologists > for start of insulin and any other recommendations. Now at 26 wks and > started fetal surveillance with biweekly NST weekly biophysical > profiles, dopplers of umbilical vessels normal and normal Middle > cerebral flow. Besides taking all the precautions for gestational > diabetic requiring insulin, does anyone have any other suggestions? > > -- > Take care, John ________________________________ Put your friends on the big screen with Windows Vista(r) + Windows ________________________________ Live(tm). Start now! <http://www.microsoft.com/windows/shop/specialoffers.mspx?ocid=TXT_TAGLM _CPC_MediaCtr_bigscreen_012008> CONFIDENTIALITY NOTICE AND DISCLAIMER The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission. If the transmission contains advice, the advice is based on instructions in relation to, and is provided to the addressee in connection with, the matter mentioned above. Responsibility is not accepted for reliance upon it by any other person or for any other purpose. Next message: Dean Huffman .: "Reproductive Health Specialist Jay Grodin, 67" Previous message: GIN11153@aol.com: "Screen all young women every year for Chlamydia, CDC urges" In reply to: Andrew Folley: "Re: Care of pregnancy in a patient who has had a Whipples procedure." Next in thread: Andrew Folley: "Re: Care of pregnancy in a patient who has had a Whipples procedure." Reply: Andrew Folley: "Re: Care of pregnancy in a patient who has had a Whipples procedure."

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