Re: Case presentation: Let's play what would you do next

From: art fougner, md (evsono@pipeline.com)
Fri Aug 25 05:53:47 2000


were the tracing non-reactive - would simply continue the tracing period. if trace nonreactive for > 90 mins - in the absence of CNS malformation or drug effect, would perform section.

art

At Thu, 24 Aug 2000, K Dew wrote: >
>24 yr old, otherwise healthy, primigravid, 40 weeks gestation by dates and
>mid second trimester scan, presents to L&D with c/o labor.
>
>Not in labor, non-reactive fetal activity study. Cervix 80%, soft,
>fingertip, -3 station.
>
>U/S two days prior to presenting to L&D, done to confirm presentation showed
>adequate amniotic fluid volume.
>
>OCT Negative. Decision made to continue pitocin as patient was term, L&D
>wasn't busy, (soft reasons I know but there they are)
>
>Still with non-reactive strip but no decels. contracted every 2 1/2 to 4
>minutes for 8 hours, pitocin level to 24 units/minute, no cervical change.
>No decelerations at all but still non-reactive. Mom claims baby is still as
>active as it usually is. (no I don't mean that usual=one time per day, but
>a reasonably active term baby) It is now 9 pm, mom tired and hungry.
>
>what would you do next?
>
>Kevin

--
art fougner, md

A series of 1000 cases begins with but a single anecdote.





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