Re: Preterm 'Macrosomia'
From: art fougner, md (evsono@pipeline.com)
Fri Dec 29 19:46:45 2000
exactamundo - sonar in first trimester = best assessment of gestational
age save ivf patient. why thrice? even moses struck the rock only
twice. any blue oxen in the vicinity?
happy millennium, folk !
art
At Fri, 29 Dec 2000, Efrain Ramirez wrote:
>
>Did you see the films? One good U/S at 9-10 weeks would suffice!! why 3?
>What did you use for tocolysis? Bet you repeat GTT at 34 weeks and get
>it "positive" . good luck.
>
>At Fri, 29 Dec 2000, Dr. Lynn Montgomery wrote:
>>
>>I have to say, I have never encountered this circumstance in my obstetric
>>career. Any Suggestions?
>>
>>38 G2 P1, currently at 29.5 weeks gestational age based on three first
>>trimester ultrasounds, referred for preterm labor, possible macrosomia and
>>polyhydramnios. On initial evaluation, has a fundal height of 42 cm and
>>cervix is fgt/80%/soft. Ultrasound gives an estimated fetal weight of 5#
>>9oz and an AFI just above the upper limit of normal at 25. Despite having
>>had three scans in the first trimester verifying dates, I don't believe
>>them, thinking that she is actually at least a month further along and I
>>amnio her for maturity. The FLM comes back at 6 (mature is 55). In other
>>words, the dates are likely correct. Monitored blood glucose values for a
>>solid week with great values-no evidence of occult diabetes.
>>
>>So, now I have basically a 6 pound baby at 30 weeks gestation. I am
>>stopping preterm labor for what seems to be primarily macrosomia. Usually
>>worrying about the smallness of a premie. In this case, I am concerned we
>>are going to have the true "original bubba".
>>
>>Lynn
>>
>>--
>>Lynn D. Montgomery, M.D.
>>Director, Maternal-Fetal Medicine
>>Rocky Mountain Perinatal Center
>>2825 Fort Missoula Rd, Suite 130
>>Missoula, Montana, 59804
>>406-327-4094
>>fax: 406-327-4154
>>e-mail: lmontgomery@communitymed.org
>>website: http://www.communitymed.org/rmpc/
>>
>--
>"Life is neither the notes nor the silence between the notes, but the music that
> arises out of sound and silence felt as a living whole. Stop choosing...between
> chaos and order, and live at the boundary between them, where rest and action
> move together..."
>
--
art fougner, md
A series of 1000 cases begins with but a single anecdote.
