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Opinions please!From: Luis Sanchez-Ramos, MD (sanchez-ramos@worldnet.att.net)Sat Feb 26 17:06:12 2000
A colleague (MFM) left me the following patient for the week-end: 24 y/o b/f G31011 at 27 weeks' gestation based on a scan performed 6 days ago (late entry prenatal care). Previous child weighed 2240 g at "term". The current pregnancy is complicated by the following: marked oligohydramnios (unresponsive to aggressive IV hydration). On ultrasound: both kidneys and bladder visualized. Dilated loops of bowel; rest of anatomy not well-delineated due to oligohydramnios. Doppler velocimetry showed (AEDV) absent end diatolic velocity. Fetus is presenting as footling breech and EFW is 1008 grams. Biophysical profile has been 6/10 (no breathing movements or reactive NST). EFM shows several variable decelerations (mild to moderate for the most part). Patient refers "good fetal activity". My partner attempted transabdominal amnioinfusion but was unsuccessful. The patietn has received two doses of betamethasone (1 course). There was some suspicion of preeclampsia with very mild elevation of systolic blood pressure. Normal labs except for elevated LDH (408 -> 261). any recommendations?? Thanks.
-- Luis Sanchez-Ramos, MD
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