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Re: A new poll!From: Marco A. Pelosi, III, MD (marcop@agoron.com)Tue Mar 20 20:32:34 2001
At Tue, 20 Mar 2001, Caitlin Cusack MD wrote: > >The list has been a sorry disappointment today-I keep logging on and >there's nothing to read! > >so-in order to try and generate some discussion-I'd like to know what >people would honestly do if put in the following situation: > >I came on for call at 7:30 and was left a G2P1 insulin requiring >gestational diabetic at 38 weeks being induced because of the GDM. Good >dates-but only 38 weeks, no tap. Fetal testing has been normal. So no >maternal or fetal indication for early induction. Prior section for >failure of descent 7lbs 2 oz-pushed for 3 hours. Pt feels this baby is >bigger, u/s shows EFW about the same. Unfavorable cervix, pitted all >day the day before, some contractions, no change in her cervix, baby not >well in the pelvis. Off of pit over night, when I came on in the am she >had been back on pit for a couple of hours for day two of her VBAC >induction. > >Here's another poll! Honestly would you: >a) Continue as is >b) Turn off the pit and send her home. >c) Tap her to at least document lung maturity >d) Turn off the pit and try a foley >e) Section her as she is not a great VBAC candidate >f) Have a discussion with your partner.... > Bring the nonsense to an halt. Don't add any more fuel to this fire. In the absence of maternal and fetal complications, this woman has no business occupying space on L&D nor being assaulted with catheters and needles. Tell your partner that if he wishes to pursue half-baked strategies, he can remain with these patients for the duration of their obstetrical management.
-- M.A. Pelosi, III, MD
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