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Re: Another Interesting VBAC From: art fougner, md (evsono@pipeline.com) Sun Jul 2 11:58:26 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: MORE ABOUT VBAC" Previous message: Eberhard W Lisse: "Re: Another Interesting VBAC" In reply to: Eberhard W Lisse: "Re: Another Interesting VBAC" Next in thread: art fougner, md: "Re: MORE ABOUT VBAC" IMHO failure to be reimbursed should be no more a reason not to order or perform an indicated test/procedure than coverage for a test/procedure be an indication to order/perform it. with regard to ultrasound, i feel this will eventually be a moot point as more folks leave residency well-trained in the use of ultrasound and begin to utilize it as part of their standard of care rather than another money-making gizmo. besides, with managed care, there is no more money. i agree with Kathi stupidity can be found no matter what letters follow the name. i'm reminded of what Oded Langer, who's now Chief at St Luke's - Roosevelt in NYC. there is an eleventh commandment handed to Moses as an afterthought for OB's - "Don't be Meshugeh! {sp?)" art At Sun, 02 Jul 2000, Eberhard W Lisse wrote: > >Tonya, > >In message <395E551D.C8DD55A2@ix.netcom.com>, "Tonya Von Brooks, CPM" writes: > >> I have one too ! G2P1 26yowf with a 39 week gestation . Desires in >> hospital Vbac . First birth 3 years ago , primary lower transverse >> C/S for fetal distress . At 36 weeks fetus found to be breech by US. > >Well, I deliver Primi Breeches (and Breeches after Cesarean) by >Caesarean. Have done so. Will do so. > >Donīt care about no evidence. Recent Advances in Obstetrics seem to >bear me out... > >> Mom did not feel gross fetal movement but clinician felt fetus vtx >> and medical doesn't pay for another US. > >Ah, the lost art of obstetrics. Now, if I couldnīt determine a breech >manually any longer Iīd do an Ultrasound whether I get paid or not. In >fact at my previous hospital (in Germany) they did an Ultrasound at >every single visit (only up to three are paid, if I am not >mistaken). And it seems to be current practice in Germany... > >Or maybe this is why the WHO puts the US behind Costa Rica in overall >health system performance. > >> Estimated fetal wt is about 3600 grams .Cervix is soft and 80%. > >> Srom, mom is induced with iv pit . > >Why was she induced? > >> Labors 12 hours asked for epidural . Epidural fails to stop pain > >How did the CTG look like at that stage? > >> . Catestropic uterine rupture , breech baby , hysterectomy for >> hemmorage . Infant demise . > >Is the obstetrician insured? > >el -- art fougner, md A series of 1000 cases begins with but a single anecdote. Next message: art fougner, md: "Re: MORE ABOUT VBAC" Previous message: Eberhard W Lisse: "Re: Another Interesting VBAC" In reply to: Eberhard W Lisse: "Re: Another Interesting VBAC" Next in thread: art fougner, md: "Re: MORE ABOUT VBAC"

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