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Re: Cephalocentesis-questionFrom: Dr.Mohamed Saeed (saeedo70@hotmail.com)Sun May 28 12:49:52 2000
Sure Sir I repeate the mother was given full informations about all the probabilities of managing such condition and all the advantages and disadvantages of each management but I thought it was quite enough to do an informed consent not a written one does it make any difference? At Fri, 26 May 2000, Marco A. Pelosi, III, MD, FACOG, FACS, FICS wrote: > >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. >> >>Now I want to be answered for the following questions: >>1. Who is the one responsible for doing trans-vaginal cephalocentesis, >>the neurosurgent or the obstetrician? > >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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