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Re: Cephalocentesis-questionFrom: Marco A. Pelosi, III, MD, FACOG, FACS, FICS (marcop@agoron.com)Fri May 26 17:11:22 2000
At Mon, 22 May 2000, Dr.Mohamed Saeed wrote: > >A 36 yrs. Old lady coming to the casuality with the following diagnosis: >P5+1, 38 weeks-gestation, cephalic, in labour, rheumatic heart disease >(mitral valve regurge with prolapse), fetus was hydrocephalic (cortical >thickness=7mm), with open spina bifida(shown by real time ultrasound and >confirmed post-natally with skin, bony, and dural loss in a dorsal >segment about 4 cm ). > >No antenatal care was done and the mother was coming in labor with >regular uterine contractions 3/10,and 3-4 cm cervical dilatation and 1.5 >cm cervical length. Fetal head was totally abdominal inspite of good >uterine contracions due to the cephalo-pelvic disproportion caused by >the hydrocephalic head. > >An informed consent was taken from the mother (husband was absent) to >perform cephalocentesis to avoid unnecessary cesarean section...................................
>The baby died 6 days after birth. The answer is obvious. A procedure with a 50%+ fetal mortality rate was performed to avoid a cesarean section - a procedure with a lower fetal mortality rate. The person who decided this course of action carries the responsibilty of its consequences. The question you will be asked: Was the mother informed of the fetal mortality risk associated with cephalocentesis when she gave consent?
-- M.A. Pelosi,III, MD
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