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Re: Opinions please! From: Ronnie Martinez Brignardello (ronniem@entelchile.net) Sun Feb 27 18:53:58 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Ronnie Martinez Brignardello: "Re: hypocalciuria in hipertensive disorders" Previous message: Paul Prior MD: "Re: questions" Maybe in reply to: Luis Sanchez-Ramos, MD: "Opinions please!" Next in thread: art fougner, md: "Re: Opinions please!" ...two things... ...i´m not sure about the amnioinfusion in this case.....the fetus had severe OHA..it could be worse...and also you were thinking in some kind of lethal anomaly and amnioinfusion ...doesn´tplay in this band (.?????) .had you done it?? .....this fetus could die in uterus while you are waiting for.....lung madurity inducction?? and if your answer is yes...are you really sure about this ?? ...would you do the same again ?? ronnie "Luis Sanchez-Ramos, MD" wrote: > At Sun, 27 Feb 2000, Braun, R. Daniel wrote: > >> By Jove, I think there is a real consensus Here<< > > We also agreed that the fetus would probably be better off in the NICU > than in the hostile environment of the amniotic cavity. However, we > were concerned with the possibility that this fetus may have had a > lethal anomaly. We were unable to delineate the anatomy due to the > severe oligohydramnios. We were able to see dilated loops of bowel > suggesting perhaps imperforate anus. There was little evidence of IUGR > by sonographic parameters i.e: transcerebellar diameter(thought not to > be affected by IUGR)was consistent with a 27 week's gestation. > Similarly, FL/AC ratio was consistent with no evidence of assymetrical > IUGR. The patient had a BP of 140/90 mmHg on a couple of occasions and > 24hr urine collection revealed significant proteinuria (500 mg)and > marked hypocalciuria (46mg/vol). Repeat BPP today was 6/10 but the 2 > points for AFV were due to the small amount of saline infused during the > attempted transabdominal amnioinfusion. She continued to show moderate > to severe variable decelerations (intermittently). This afternoon the > patient was delivered by cesarean (frank breech)and the neonate weighed > 980 gm and had Apgar scores of 7/7 at 1 and 5 minutes respectively. The > neonate of course was admitted to the NICU. I haven't heard of any > anomalies but it appeared to be normal. I want to thank everyone for > their opinion(s). > > Luis Sanchez-Ramos, MD Next message: Ronnie Martinez Brignardello: "Re: hypocalciuria in hipertensive disorders" Previous message: Paul Prior MD: "Re: questions" Maybe in reply to: Luis Sanchez-Ramos, MD: "Opinions please!" Next in thread: art fougner, md: "Re: Opinions please!"

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