Re: Placenta Accreta
From: Betsy Hyde (elishyde@att.net)
Fri Feb 15 14:05:33 2008
This issue came up yesterday at Grand Rounds.
Evidence was presented that ultrasound was as good as CT/MRI for
abnormal placentation, and no good evidence had been presented that
balloon catheters were beneficial. Although some of the studies
showed benefit, others should major complications including need for
ileofemoral bypass!
--
Betsy Hyde CNM
Branford, CT
On Feb 15, 2008, at 3:53 PM, art fougner, md wrote:
> If your hospital has a first rate interventionl radiology department,
> prophylactically catheterizing the internal iliacs can be a lifesaver.
>
> Art
>
> At Fri, 15 Feb 2008, ainsron wrote:
>>
>> Be prepared for C-Hysterectomy - consent, blood available (lots).
>> MRI could
>> be useful for diagnosis, but at this point it sounds like it is
>> highly
>> likely, so what difference would an MRI make? Either way you're
>> going to
>> need to be prepared for C-hysterectomy. If it doesn't separate
>> easily I
>> would go quickly to hysterectomy. If she wanted conservative
>> options, I
>> would refer to tertiary care center and let them roll the dice if
>> they feel
>> lucky. For my part, I would do everything I can safely do to
>> protect the
>> patient, not the uterus.
>>
>> Ronald E. Ainsworth, MD, FACOG
>>
>> -----Original Message-----
>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>> Andrew
>> Folley
>> Sent: Friday, February 15, 2008 9:53 AM
>> To: Multiple recipients of list OB-GYN-L
>> Subject: Re: Placenta Accreta
>>
>> G3P2 now at 27 weeks with know complete previa since 12 weeks.
>> Admit to
>> hospital wednesday for steroids in light of short cervix or 9mm
>> and +Ffn.
>> Echo in hospital confirms previa and also suggests placenta
>> accreta on
>> "right lateral side". Patient would like more children. Any
>> thoughts on
>> management?? ie plan for c-hyst? Use interventional radiology? Do
>> c-section
>> and leave placenta and treat with methotrexate? Do section and do
>> the best I
>> can in extracting placenta and be prepared....???? thanks agf PS
>> Benefits
>> tif any for Cat scan or MRI to diagnose percreta or increta??
>>
>>> Date: Tue, 29 Jan 2008 17:05:21 -0600
>>> From: dean@thehuffpeople.net
>>> To: ob-gyn-l@mail.obgyn.net
>>> Subject: Re: ABC / MOC with ABOG Question
>>>
>>> .
>>>
>>> Do not feel dumb. ABOG has screwed it up completely.
>>>
>>> First you have to go to http://www.abog.org and sign in with your
>>> special ID and
>>> Password. (It you do not have one, or do not know what it is, you
>>> can call
>> them
>>> on the phone).
>>>
>>> Then you have to complete the registeration for the 2008 board
>>> exam and
>> mail or
>>> fax it in to them. DO NOT FORGET TO SEND THE MONEY.
>>>
>>> Then you can go on their web site and find the article references
>>> and
>>> questions.
>>>
>>> - - - -
>>>
>>> From: "Garry E. SiegelSubject: Re: ABC / MOC with ABOG Question
>>> Date: Jan 29, 2008 1:32 PM
>>>
>>> OK, I'm feeling a bit dumb.
>>>
>>> Where is the link/what is the link to find the article list and
>>> questions
>> on
>>> ABOG's site? I seem to be missing it. . .
>>>
>>> Last year, it was a .pdf that included the 60 questions and
>>> reading list,
>> around
>>> 15 pages to print.
>>>
>>> Please post or email privatetly.
>>>
>>> Thanks,
>>>
>>> Garry
>>>
>>> --
>>> Garry E. Siegel, M.D.
>>> Private Practice
>>> Roswell, GA
>>>
>> _____
>>
>> Shed those extra pounds with MSN and The Biggest Loser! Learn
>> <http://biggestloser.msn.com/> more.
>
> --
> art fougner, md
> "May The Wings of Liberty Never Lose a Feather." - Jack Burton
