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Re: Case presentation: Let's play what would you do next From: Steve & Eryl Raymond (eryl@intekom.co.za) Fri Aug 25 12:11:27 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Steve & Eryl Raymond: "Re: Would you do it again??" Previous message: D. Ashley Hill, MD: "Re: Would you do it again-long reply to Alexandra." In reply to: K Dew: "Case presentation: Let's play what would you do next" Next in thread: Len2976@aol.com: "Re: Case presentation: Let's play what would you do next" This scenario could have been predicted because the membranes remain intact. They should have been ruptured after 2 to 4 hours. Now you're faced with either rupturing them at this stage and continuing for another 2 to 4 hours or doing a caesarean! There is something to be said for backing out of this attempted induction, and sending her home to await spontaneous labour, but the CTG is not wonderful, and I get uneasy about women at term who don't establish in labour easily. I would do the C/S now. She's well past the action line of the partogram and the baby is not going to do well with mother ketotic. On 24 Aug 2000, at 21:38, 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. It is now 9 pm, mom tired and hungry. Dr. Steve Raymond Head of Department of O & G Empangeni Hospital Empangeni SOUTH AFRICA 3880 Ph:(+27)(035)77721111 Next message: Steve & Eryl Raymond: "Re: Would you do it again??" Previous message: D. Ashley Hill, MD: "Re: Would you do it again-long reply to Alexandra." In reply to: K Dew: "Case presentation: Let's play what would you do next" Next in thread: Len2976@aol.com: "Re: Case presentation: Let's play what would you do next"

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