Re: Macrosomia 'management'
From: art fougner, md (evsono@pipeline.com)
Thu Feb 10 12:16:03 2000
Deborah,
what does your patient think about this? also, what are the feelings of
your Ob consultants?
Art
At Thu, 10 Feb 2000, Deborah Wage, FNP,CNM wrote:
>
>1 hour normal. u/s congruent with clinical measurements. And all appropriate counseling has been done (regarding shoulder dystocia risk and associated damage)etc .
>
>--
>Deborah Wage,FNP,CNM
>
>"Americans will always do the right thing, after they have exhausted all the other possibilities."
>Winston Churchill
> -----Original Message-----
> From: Mark G. Newman <mgnewman@flash.net>
> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net>
> Date: Thursday, February 10, 2000 4:37 AM
> Subject: Re: Macrosomia 'management'
>
> 2 questions: Is clincal estimate congruent with US measurement? Was her 1 hour glucose screen COMPLETELY normal?
> If at all abnormal, would proceed with C/S
> If it was, would discuss with patient risk of dystocia due to macrosomia...I would quote about a 15% risk in that size, nondiabetic infant, and say that 1-5% of those with dystocia have some permanent sequelae, some VERY serious. That is probably overstating the risk for permanent problems.
> If the patient agreed, proceed with delivery, but await natural labor.
> C/S for any protraction/arrest disorder.
> There is very little science involved in that management scheme.
>
> My $0.02
>
> Mark Newman
> Perinatal Associates of Texas
>> ----- Original Message -----
> From: Deborah Wage, FNP,CNM
> To: Multiple recipients of list OB-GYN-L
> Sent: Wednesday, February 09, 2000 11:12 PM
> Subject: Macrosomia 'management'
>
> 21 year old primigravida at 39 weeks and 3 days. Baby is 4687 grams. Who would induce her now? Who would induce her in a week? Who would offer elective section? Who would just await spontaneous labor? Cervix 40%/2-3/-2.
>
> Deborah Wage, MSN, FNP, CNM
>
--
art fougner, md
and what am i gonna do with all this food, bottled water,
and gasoline now that armageddon was called off for lack
of interest?
