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Re: twins with progressive cervical change. From: art fougner, md (evsono@pipeline.com) Fri Mar 9 06:52:28 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry Siegel: "Re: twins with progressive cervical change." Previous message: DMECNM@aol.com: "Re: Query the group" In reply to: Steve & Eryl Raymond: "Re: twins with progressive cervical change." Next in thread: Garry Siegel: "Re: twins with progressive cervical change." Reply: Garry Siegel: "Re: twins with progressive cervical change." another alternative to cerclage is a smith hodge pessary. art At Fri, 9 Mar 2001, Steve & Eryl Raymond wrote: > >Yes - stitch by all means, but remember that a stitch doesn't solve the problem >of prem labour, and warn her that the prognosis is poor. It's long past time to >stop the indomethacin, however. You might change to Nifedipine. > >"Kleinman, Dr. Gary E." wrote: > >> The patient is 35 years g1 infertility patient with twins (dichorionic) now at >> 23+1 week's gestation. Admitted 3 weeks ago with right pelvic pain and >> cervical length = 1.3 cm on transvaginal sono, with funneling. Contractions >> were present them, 4-6/hr. Started on indomethacin and oral terbutaline, then >> 1 day later, indomethacin and terbutaline pump. BV gram stains negative. No >> evidence of infection. Patient contracts 1-2x/hr on tocolytic. 4 days ago, >> could not measure intact cervical length on ultrasound, but cervix felt >> closed. Today, cervix is open , by palpation, 1-2 cm with amniotic sac >> funneling to cervical os. Cervix feels 50% effaced. >> >> Patient placed on magnesium sulfate and indocin continued. Called Southwestern >> Multiple Gestation Mecca for advice. Their perinatologist, said that a >> cerclage would be reasonable because there was little else to offer, however >> he was unsure of the benefit of this. >> >> I feel ready to stitch. I wonder if our community agrees. >> >Dr. S.H. Raymond >Department of Obstetrics & Gynaecology >Empangeni Hospital >Private Bag X20005 >Empangeni >South Africa 3880 >Ph. (+27) (035) 7721111 >Fax (+27) (035) 7922596 -- art fougner, md A series of 1000 cases begins with but a single anecdote. Next message: Garry Siegel: "Re: twins with progressive cervical change." Previous message: DMECNM@aol.com: "Re: Query the group" In reply to: Steve & Eryl Raymond: "Re: twins with progressive cervical change." Next in thread: Garry Siegel: "Re: twins with progressive cervical change." Reply: Garry Siegel: "Re: twins with progressive cervical change."

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