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Re: procardia for chronic tocolyisFrom: Andrew Folley (agfolley@hotmail.com)Thu Oct 30 10:28:34 2008
What I would do in that situation is to give steroids, start procardia 20 q 6hrs, observe 48 hrs to 72 hrs in hospital. No antibiotics, check GBS culture and Urine culture and send home no meds. See Procardia will not stop her labor and is of no benefit for chronic tocolysis. It may decrease some of her uterine irritability although I do not think there is any clinical evidence for this. No benefit shown from hosptitalized bedrest verses home. agf> Date: Wed, 29 Oct 2008 21:25:43 -0500> From: garrys@mindspring.com> To: ob-gyn-l@mail.obgyn.net> Subject: Re: procardia for chronic tocolyis> > In general, if I use Procardia for tocolysis, I'll keep them on it until> 35 weeks.> > Speaking for myself, I try not to use tocolysis unless there is cervical> change associated with contractions.> > That said, I recently had a set of 30w4d twins who was feeling pressure.> Her cervix was 0/50/-1 (very low) and an FFN was positive. She was> irritable.> > Would you treat with Procardia or something else while giving steroids?> > If she is stable after steroids, would you keep her on it?> > Garry> > At Wed, 29 Oct 2008, Andrew Folley wrote:> >> >Questioning the benefits of leaving on procardia until 34 weeks? ie In the interest of evidenced based medicine are are we treating the patient or the physician?> Date: Wed, 29 Oct 2008 10:03:42 -0500> From: el@lisse.NA> To: ob-gyn-l@mail.obgyn.net> Subject: Re: procardia for chronic tocolyis> > I keep them on Nifedipine 10mg 8hourly for a while under the assumption> that it increases bloodflow to the uterus and has virtually no side> effects.> > What's the issue?> > el> > > on 10/29/08 4:46 PM Andrew Folley said the following:> > Does anyone use procardia on a chronic basis for patients syptomatic> > with prematrue labor?> > Typically we will have someone admitted with PML and short cervix (ie> > <15mm) and they receive procardia and steroids. Usually are then left> > on procardia 10-20mg q 6 hrs indefinitely. Is this a routine anywhere> > else and is there any danger in this? I am familiar with cochrane study> > showing no befefit to chronic tocolysis. andy>> > --> Garry E. Siegel, M.D.> Private Practice> Roswell, GA
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