Re: Opinions please!

From: Efrain Ramirez (eramirez@icepr.com)
Sun Feb 27 08:49:14 2000


C/S -- neonatolgists may have a hard time but he will do better than inside her uterus.

At Sat, 26 Feb 2000, Luis Sanchez-Ramos, MD wrote: >
>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
>

--
"The things you learn after you know everything are the important ones"




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