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Re: OB: Complete Previa, AnteriorFrom: Joanne Bulley, MD (jbulley@cheshire.net)Wed May 31 21:40:37 2000
My last Ob was September 1998, but... At Wed, 31 May 2000, Garry E. Siegel wrote: > >When approaching a patient at C/S for a complete previa, with an >anterior component, what do the listers do differently, if anything? > >In this case, it is a primigravida undergoing a scheduled section at >37.5 weeks. > >Issues: > >1. When do you section the known previa who is not bleeding, but has >bled before requiring hospitalization? 37, 38, 39 weeks? Amnio if less >than ____? weeks?
My choice would be 38 weeks - no amnio, *assuming* carestarted early so
that fdates are excellent. If it appeared she would not last til 38
weeks, I'd love to get 37-37.5 If she was bleeding enough to make me
consider/decide to deliver <37 weeks - just notify Pedi. Occasionally
amnio - but usually not.
>
Transverse, maybe a bit larger - mainly make sure the transverse fascial
cut is wide enough - that's usually more important than the skin
incision length.
> Usually went right through the placenta - quickly and got the kid out and cord clamped! Of course - is it's before 36 weeks - depends on the development of the lower uterine segment.
>Food for thought. Good Night.
-- Joanne Bulley, MD Keene, NH, USA
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