Re: new case

From: Steve & Eryl Raymond (eryl@intekom.co.za)
Tue May 30 15:12:28 2000

Just one final question - Was this patient an African American? In other words is there a racial difference? We certainly have a very strong feeling that there is here in South Africa.

On 29 May 2000, at 22:48, Betsy Hyde wrote:

> a number of list members have written about uterine ruptures, and
> fetal demise. There has been some suggestion that perhaps an unknown
> uterine defect (physiologic, related to infection, perhaps due to to
> uterine anatomy, perhaps due to prior uterine surgery) has resulted in
> a fetal demise, first, and then a rupture secondary.
>
> I sure as hell don't have the answer to this....but I know that
> observation of phenomenon, and questioning of the occurence, often
> times leads to an explanation...or at least proposes an hypothesis for
> future testing.
>
> This woman had minimal contractions. She was given misoprostil, and
> then pitocin in a manner which is well within the standard of care.
> There was no apparent reason for rupture. She had an IUFD prior to the
> rupture, but it seems to me that we need to at least think about this
> case, and ponder whether there were any predisposing factors. Was a
> prior existing condition the cause of demise, and then the
> rupture....or was the rupture due to intrapartum management? I don't
> know the answer, nor do any of you....but this is a topic worthy of
> discussion, IMO.
>
> On this list, there is a wealth of experience with IOL....miso, PG,
> pit.....I was perhaps mistakenly under the impression that this was a
> forum for discussion of puzzling cases of this nature....if not, I
> truly apologize.

Dr. Steve Raymond Head of Department of O & G Empangeni Hospital Empangeni SOUTH AFRICA 3880 Ph:(+27)(035)77721111



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