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Re: Prior cesarean, SGA, need your help.... From: Douglas L. Madsen (dlmmd@fidalgo.net) Thu Jul 31 00:44:51 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: MajMahan@aol.com: "Re: C/S and stature" Previous message: Douglas L. Madsen: "Re: Lupus anticoagulant and pregnancy" Maybe in reply to: Geffrey H. Klein, MD: "Prior cesarean, SGA, need your help...." Next in thread: Jose C. Ferreira: "Re: Prior cesarean, SGA, need your help...." I don't know if this is a regional preference or not, but a fluorescent polorization test of amniotic fluid seems to have less false negs as I suspect may be the case here. Now that you have walked down the path of documenting lung maturity, you probably have no choice but to document lung maturity before *elective* C/S. If fetus shows any signs of compromise or pt. starts labor, deliver without lung maturity documentation. Doug Madsen MD FACOG Pvt. Practice Mount Vernon, WA >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 >http://www.obgyn.net/medical.htm >Office: >2200 Nasa Rd #1 >Houston, Texas 77058 >Tel 713 741 2273 x2628 >page 713 415 4395 Next message: MajMahan@aol.com: "Re: C/S and stature" Previous message: Douglas L. Madsen: "Re: Lupus anticoagulant and pregnancy" Maybe in reply to: Geffrey H. Klein, MD: "Prior cesarean, SGA, need your help...." Next in thread: Jose C. Ferreira: "Re: Prior cesarean, SGA, need your help...."

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