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Re: new case;labor is also a uterine muscolar work From: sanbonav@tin.it Tue May 30 10:43:38 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Lynn Montgomery: "Re: Zovirax / Valtrex beyond" Previous message: Luis Sanchez-Ramos: "Re: new case" In reply to: Joanne Bulley, MD: "Re: new case" Next in thread: Luis Sanchez-Ramos: "Re: new case" >reading all responses to this case I am quite surprised to see >that nobody remembers that labor is also a uterine muscolar work >So as You prepare yourself before running drinking salts and energetic >substancies to avoid cramps in legs during footing , You have to prepare >uterus (to avoid irregular contractions that means cramps,pain for mother, >stress for fetus and inefficient uterine dilatation)by administrating fluids >before labor induction or at the beginning of labor >In my Department I suggested fluid-loading therapy :the administration of 250 cc of >glucose-6-Phosphate solution and 500cc of Darrow(elettrolitical) solution intravenously > before induction to avoid uterine ipertonus or at the beginning of spontaneous labor >to have regular no-distressing uterine contractions. >electrolite dosage before therapy is unuseful ,time and money consuming. >My midwifes are very satisfied about the results ,and now they do it with every woman >in labor >Hope this helps >Yours faithfully >Emilio Porro M.D. > >At Mon, 29 May 2000, Betsy Hyde wrote: >> >>At 10:17 AM 5/29/00, Luis Sanchez-Ramos, MD wrote: >> >>>It is hard for me to believe that a patient with an unscarred uterus >>>would suffer a catastrophic uterine rupture with two separate 25 mcg >>>doses of misoprostol (adminestered to apatient who is not having regular >>>uterine activity). >> >>these are the facts. The woman received 2 25 mcg doses of misoprostil, 4-6 >>hours apart. Our institutional protocols state that doses will not be >>repeated if contractions are more frequent q 3-4 minutes. The second dose >>was given only because she was *not* contracting. After the second dose she >>had a brief period of very painful contractions, and developed tachycardia. >>The contractions then stopped. Not detectable on the monitor and not >>reported by the woman. >> >>The purpose of my post was to elicit the opinions of list >>members in nailing down a reason for tachycardia, SOB and abdominal pain in >>a woman who had delivered a stillborn fetus. At the time of my post, >>neither I nor my OB attending, cardiologist, MFM consult, or general >>surgeon knew she'd sustained a uterine rupture. The diagnosis was made at >>surgery, well after I posted this case. Although uterine rupture was >>include in my list of differentials (along w/ PE and AFE), there was no way >>to confirm the diagnosis. >> >>I posted this case because it was a puzzle. I don't think I deserved the >>comments that we shouldn't ever use miso because we don't know how to use >>it, that we are "eager to make public these occurrences", and that I am, in >>some way attempting to hide other examples of uterine rupture in my >>practice. I am not. >> >>It is certainly disappointing that a straight-forward posting of an >>interesting (to me) clinical case is met by such hostile replies by someone >>with such a wealth of experience in the area of misoprostil use. >> >>-- >>Betsy Hyde CNM >>Assistant Clinical Professor, Yale University >>Director, Midwifery Services >>Obstetrics-Gynecology-Infertility Group, PC >>New Haven, CT >> > Porro Emilio Ob-Gyn.M.D. Via Zezio 69 22100 COMO (Alessandro Volta City) ITALY phone:031/30 21 46 e-mail: sanbonav@tin.it sanbonav@hotmail.com Who,Whom,Which,With,What,Why,Where,When,Whose,Whole,Want,Wether,While,Whatev er,Watch WORLD WIDE WEB moneyfree informations about birth labour pain control and mother and fetus wellbeing at http://www.sanbonaventura.com Next message: Lynn Montgomery: "Re: Zovirax / Valtrex beyond" Previous message: Luis Sanchez-Ramos: "Re: new case" In reply to: Joanne Bulley, MD: "Re: new case" Next in thread: Luis Sanchez-Ramos: "Re: new case"

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