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Re: inductions From: dahmd@gate.net Sun Oct 1 14:51:51 1995 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: VladimirT@aol.com: "Shoulder Dystocia and the "all fours maneuver"" Previous message: Robbrenner@aol.com: "unindicated sonograms" Maybe in reply to: Robbrenner@aol.com: "inductions" Next in thread: Dr. Carlos Chase: "Re: inductions" In article Robbrenner@aol.com writes: >Date: Sun, 1 Oct 1995 13:26:50 -0500 >Reply-To: ob-gyn-l@listserv.bcm.tmc.edu >From: Robbrenner@aol.com >Subject: inductions >The issue of elective inductions is being resolved by the managed care >companies. We have noted that several companies will not authorize induction >of labor unless there is a medical indication. The hospital cost is greater >for induced labor vs. spontaneous onset. >Robert Brenner MD >Baltimore MD >Robbrenner@aol.com I agree. Not too long ago we had a patient with chronic hypertension and Class B diabetes at term who had a Bishop's score of about 5, underwent vaginal prostin x 3, then oxytocin induction. Baby was about 3600grams. She underwent a 3 day induction, progressed to complete, and could not bring the baby down past -1 station (OP with acynclitism). She had a c/section complicated by atony with a 1500cc blood loss, with uterine artery ligation. Of course she developed endomyometritis. And, of course, I got the ubiquitous call from the insurance agent...except, I got the call during the third day of her induction! She wanted to know why she had "stayed 3 days when she is only authorized for 48 hours". This was for an indicated induction. My patients are already getting grief for refusing a trial of labor after a c/section. I wonder when they'll start cracking down on social inductions. D. Ashley Hill, M.D. dahmd@gate.net Next message: VladimirT@aol.com: "Shoulder Dystocia and the "all fours maneuver"" Previous message: Robbrenner@aol.com: "unindicated sonograms" Maybe in reply to: Robbrenner@aol.com: "inductions" Next in thread: Dr. Carlos Chase: "Re: inductions"

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