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Re: IUFDFrom: Braun, R. Daniel (rbraun@iupui.edu)Tue Apr 25 08:32:12 2000
I think it would be OK to try a little labor and see how the cervix dilates. If it does, an Internal Podalic Version might work. Or it might even just rotate on its own with a few contractions. 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: donald.wiersma@misawa.af.mil [mailto:donald.wiersma@misawa.af.mil] Sent: Tuesday, April 25, 2000 7:56 AM To: Multiple recipients of list OB-GYN-L Subject: Re: IUFD A couple thoughts, 1. Though earlier in pregnancy most would "pit it out" without regard to presentation there is no way this big transverse baby is going to deliver vaginally. To try would just put her at risk of all the prolonged obstructed labor risks. 2. External cephalic version was a good idea. Unfortunately the chances of success are probably very decreased postterm with a macrosomic baby. A second attempt under regional anesthesia could be considered. Some studies have shown better success with epidural, at least one did not. I bet none of these were done at this EGA or EFW though. If you did try again you could also try turning the baby breech if a turn to cephalic did not work. No problem delivering this one breech. 3. You could try ECV again under regional if she is really eager for a vaginal delivery but since the chance of success is low... I would just do a hysterotomy.
-- Scott Wiersma, MD, FACOG Misawa Air Base, Japan
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