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Re: Prior cesarean, SGA, need your help.... From: Malcolm Griffiths (malcolm@mgriff22.demon.co.uk) Thu Jul 31 15:17:34 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Betsy Hyde: "Estrogen supplementation of premenopausal woman" Previous message: Bernard Cristalli: "Re: Denmark the Csection rate is about 3%" In reply to: Geffrey H. Klein, MD: "Prior cesarean, SGA, need your help...." Next in thread: Terry J. DuBose: "Re: Prior cesarean, SGA, need your help...." In message <v03007809b0059f955e27@[208.2.63.83]>, "Geffrey H. Klein, MD" <gklein@bcm.tmc.edu> writes >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. > >Questions: >1) Should I have just sectioned her? There is a fundamental difference between US and the rest of the world. With certain dates (as here) we don't do LS ratio at this gestation (in fact we don't ever do it !). I assume that you have acceeded to her request for CS rather that trial of VBAC. I'd therefore section her at 38+ weeks unless measures of fetal well-being are non-reassuring before then. >2) Now that I documented immature lungs, what should I do? There is a fundamental difference between US and the rest of the world. With certain dates (as here) we don't do LS ratio at this gestation (in fact we don't ever do it !). I assume that you have acceeded to her request for CS rather that trial of VBAC. I'd therefore section her at 38+ weeks unless measures of fetal well-being are non-reassuring before then. !!! :-) -- Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt Obstetrician & Gynaecologist Luton & Dunstable Hosp., LU6 2DT, UK. Tel: 01582-497459 (office) Fax: 01582-497376 01525-222849 (home) email: Malcolm@mgriff22.demon.co.uk http://www.obgyn.net/board/griffith.htm "It is dangerous to be right on a subject on which the established authorities are wrong." (Voltaire) "But sometimes it's fun :-)" (Griffiths) Next message: Betsy Hyde: "Estrogen supplementation of premenopausal woman" Previous message: Bernard Cristalli: "Re: Denmark the Csection rate is about 3%" In reply to: Geffrey H. Klein, MD: "Prior cesarean, SGA, need your help...." Next in thread: Terry J. DuBose: "Re: Prior cesarean, SGA, need your help...."

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