|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: vasa praevia was home deliveryFrom: Anna Meenan, MD (annam@uic.edu)Fri Oct 27 13:13:33 2000
At Fri, 27 Oct 2000, RModugno@aol.com wrote: > >In a message dated 10/27/00 3:03:31 AM Eastern Daylight Time, >midwife@oldwest.net writes: > ><< It gave me the willies to imagine the dangers of a vasa praevia in the > hospital.. > >> > >So, Paula, this great series of one very fortunate episode ( or a "near miss" >as our airline industry colleagues would say) leads you to believe that it's >"safer" to deliver a patient with vasa previa out of a hospital? Also, on >what evidence do you base your statement about the "dangers" of a vasa previa >in the hospital? Please, enlighten us! > >Robert Modugno MD MBA FACOG >Marietta, GA I'm not sure that Paula was trying to convince anyone that it is safer to deliver a vasa previa at home (or in a van). I think her point was that in THIS case, it was better that the bag was left alone until it descended to the point where one could SEE the vasa previa, and the baby was ready to deliver promptly. One could make a case for the safety of leaving the bag intact until very late in labor (which many home birth midwives do) vs. being impatient, especially with second twins, and possibly rupturing a vasa previa before the baby is ready to come. You must admit that early rupture of membranes, before birth is imminent, probably happens much more often in the hospital. I am NOT saying it is safer to deliver vasa previas at home, but perhaps some of the routine practices of midwives make it less dangerous than we would necessarily think it was. However, I am sure any midwife worth her salt would immediately transport to a hospital if they felt a vasa previa before rupturing membranes. By the way, if Paula's patient had been seeing a traditional obstetrician and had not had Paula around, she would have had an unattended out-of-hospital birth, which everyone agrees is THE most dangerous kind.
-- Anna Meenan, MD, FAAFP
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 04:46:07 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.