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Re: preterm labor view from an OBGYN who has been through it From: Braun, R. Daniel (rbraun@iupui.edu) Thu Feb 17 15:27:33 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: Inappropriate Hysterectomies ( Long)" Previous message: Efrain Ramirez: "Re: Route of delivery in Genital Herpes" Braxton-Hicks contractions are PAINLESS uterine contractions first described by Sir John Braxton-Hicks in the 1600's as a pregnancy test. If you could feel painless contractions, it was a pregnancy and not an ovarian tumor. Dan R. Daniel Braun, MD FACOG Clinical Professor Department of Obstetrics and Gynecology Indiana U. School of Medicine Indianapolis, IN 46202 OBGYN.net International Representative for United States Certified AllExperts Expert Check out my bio/ratings page! http://www.allexperts.com/displayExpert.asp?Expert=1236 -----Original Message----- From: steve [mailto:steve@dhngwe2.db.healthlink.org.za] Sent: Thursday, February 17, 2000 12:26 PM To: Multiple recipients of list OB-GYN-L Subject: Re: preterm labor view from an OBGYN who has been through it Doesn't anybody tell patients about Braxton-Hicks contractions anymore? > Well, Annette, your experience is similar to mine - except I chose to not > tell folks about the contractions - 20 weeks in my first pregnancy, > deliviered at 40 0/7; 16 weeks in my second, delivered at 40 1/7. I > modified my activity and fluid / calorie intake if the contractions > increased and never had to do any tocolytics probably because I chose to > not tell.... Yes we over treat and I have said as much to partners > through the years, but would go along with the group practice's general > overtreatment so as to not have the patients caught in the middle. Joanne > Bulley private practice General Gynecologist now - was general ObGyn > > >Bottem line is that from someone who has been on both > >sides as the patient and as the doc, I think that we > >"overtreat" a lot of "preterm labor". I can certainly > >understand that especially when treating a collegue, > >you don't want to miss it, but I believe in many cases > >a multip can tell what feels real and what does not. > >In all 3 cases, I guess it could be considered a > >tocolysis success story, but I think that the outcome > >would have been the same without any treatment at all, > >which is what we plan for the next pregnancy. In the seventies Boehringer Ingelheim produced Berotec (fenoterol) under a different name for use in prem labour - they called it Partusisten. Because Berotec tablets had been available for asthma for some time I asked them to help me with a double blind placebo controlled trial of oral therapy in prem labour. I was working in a small unit at the time and found it very difficult to get the numbers I needed to achieve a reasonable power. In the end I didn't get my numbers but broke the code anyway and found to my surprise that those on placebo had longer pregnancies than those on fenoterol. I never worked out the significance of the numbers but I doubt that there was a low P value. About that time interest in prolonging pregnancies any longer than needed to administer steroids began to wane so I did no more than present the findings to a group of young Obstetricians in a low power socio-scientific weekend. Since then I have thought no more about it. It seems to me that I didn't really waste the time but rather re-invented a cart wheel in the jet age. -- Steve Raymond Dr. S.H. Raymond Head of Department of O & G Empangeni Hospital EMPANGENI South Africa 3880 Ph. (27)+(35)7721111 Fax (27)+(35)7922596 Next message: art fougner, md: "Re: Inappropriate Hysterectomies ( Long)" Previous message: Efrain Ramirez: "Re: Route of delivery in Genital Herpes"

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