Re: Prior cesarean, SGA, need your help....

From: Ronald R Helm (rrhelm@juno.com)
Wed Jul 30 21:11:45 1997


I would continue surveillance and retap in one week. If evidence of lung maturity, section per patients wish. Ron

On Wed, 30 Jul 1997 20:49:08 -0500 "Geffrey H. Klein, MD" <gklein@bcm.tmc.edu> writes: >Hi all..
>
>New case
>
>27 y/o G4P1A2 started prenatal care with this office at 31 wks
>gestation.
>Prior doctor did ultrasound at 15 wks supporting due date of 8/16/97.
>Patient has prior cesarean section with an LUT incision. Patient
>refusing
>TOL. Ultrasound was ordered 7/14/97 due to size less than dates. EFW
>at
>35 3/7wks by U/S was 1900g (~10%). Repeat U/S by me on 7/15/97 (I did
>not
>have the report until later that day) was 2200g (greater than 10%) but
>head
>was 35 wks and body was 33 wks. AFI was 20. At that point I decided
>to get
>weekly NST's which have been reassuring.
>
>I had her at the hospital today at 37 4/7 wks.
>
>Strip was reactive. No contractions.
>
>My plan was to tap and deliver if mature...
>L/S was 1.2 and PG was 0.0.
>
>Questions:
>1) Should I have just sectioned her?
>2) Now that I documented immature lungs, what should I do?
>
>----------------------------------
>Geffrey H. Klein, MD
>----------------------------------
>gklein@bcm.tmc.edu
>----------------------------------
>http://members.aol.com/gklein01/geff.html
>List-owner OB-GYN-L
>co-moderator sci.med.obgyn
>Advisory Board Chairman OBGYN.net
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>





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