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Re: routine intrapartum labs From: Geffrey Klein, MD (gklein@icsi.net) Sun May 28 11:02:06 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr.Mohamed Saeed: "Re: Cephalocentesis-question" Previous message: Braun, R. Daniel: "Re: Stump the Professors (from placental pathology)" In reply to: Efrain Ramirez: "Re: routine intrapartum labs" Next in thread: Efrain Ramirez: "Re: routine intrapartum labs" Reply: Efrain Ramirez: "Re: routine intrapartum labs" At 9:14 AM -0500 on 5/28/00, Efrain Ramirez wrote: > >paying any money for this information is too much. > >Not for me - we have 21 years to confirm that. > >>Ok.. I will ask you then, how does knowing the cord gas alter your >>management in the following cases... >> >>1) vigorous term infant with apgars 9,9 and a cord pH of 6.95, BE -15 > >Strange - but in general a vigorous child with a low pH and low HCO3 >--alert the pediatrician for neonatal sepsis -I could not find a fine >article written a few years back looking into that issue. One issue >about selecting the cord gases is your judgement on what constitutes a >"normal" labor - what's a normal/abnormal FHR tracing, etc.- it varies a >lot - from one MD to another - disagree.. septic baby will be picked up in the nursery due to tachypnea, poor feeding, poor temperature regulation, elevated wbc ct.. the cord gas was not needed.. > >>2) depressed 26 week infant with a cord pH of 7.35, BE -5 > >Normal finding and a good start for the baby. and your management was changed in what way?? > >>Please give me an example of a case where the result of the cord gas >>will change your clinical management.. > >You are missing the point Geff - it's not changing MY management - it's >an objectice data of events around labor and delivery. so, as a patient why should I pay for it? Let me put it another way.. Apgar scores are done to alert the pediatrician that the baby needs resuscitation, blood pressure is measured because high or low blood pressure can indicate the need to act, and the same for respiratory rate. These are objective data, as well.. As a patient, I am willing to pay for this because the result of the test effects the management of my condition. This is not the case with cord gasses. -- _______________________ Geffrey H. Klein, MD _______________________ geffrey.klein@obgyn.net 200 Medical Center Blvd Suite 103 Webster, TX 77598 (281) 332 6723 http://www.geffreyklein.com Next message: Dr.Mohamed Saeed: "Re: Cephalocentesis-question" Previous message: Braun, R. Daniel: "Re: Stump the Professors (from placental pathology)" In reply to: Efrain Ramirez: "Re: routine intrapartum labs" Next in thread: Efrain Ramirez: "Re: routine intrapartum labs" Reply: Efrain Ramirez: "Re: routine intrapartum labs"

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