Re: IUFD
From: ainsron@msn.com
Tue Apr 25 09:13:44 2000
That was my feeling, nothing heroic, but I still think it is worth a
try. I hate doing a C/S for a dead fetus, but sometimes . . .
>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?Expert36
>
>-----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
>
--
Ronald E. Ainsworth, MD
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