Re: IUFD
From: ainsron@msn.com
Tue Apr 25 10:39:30 2000
She had two doses of cytotec during the night, 25 mcg, followed by 50
mcg 4 hours later. Entered an active labor pattern. 4 hours later SROM
occurred and she is now 7 cm at 0 to +1 station, complete breech. Keep
your fingers crossed.
>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
>
--
Ronald E. Ainsworth, MD
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