-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: OB: Fun with preeclampsia--very long! From: Braun, R. Daniel (rbraun@iupui.edu) Fri Jul 27 12:55:38 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dean Huffman: "Woman in coma delivers healthy baby" Previous message: Charlie Chambers: "Re: OB: Fun with preeclampsia--very long!" Maybe in reply to: Garry Siegel: "OB: Fun with preeclampsia--very long!" Next in thread: Steve & Eryl Raymond: "Re: OB: Fun with preeclampsia--very long!" I am aware of one patient (log time ago) who had a clostrial infection and died secondary to this use. Dan R. Daniel Braun, MD "If everybody likes you, you've got to be doing something wrong." Kinky Friedman -----Original Message----- From: Charlie Chambers [mailto:cchamber@alumni.rice.edu] Sent: Friday, July 27, 2001 12:52 PM To: Multiple recipients of list OB-GYN-L Subject: Re: OB: Fun with preeclampsia--very long! on 7/27/01 10:32 AM, Garry Siegel at garrys@mindspring.com wrote: >>> >>> Well, we've got a problem already. You're diagnosing her with "severe >>> preeclampsia" when you've found that she has no proteinuria. Please explain. >>> What diagnostic criteria do you use? >> >> Bob, severe pre-eclampsia can certainly occur in the absence of >> proteinuria. Been there, done that. Variant of HELLP basically. >> Having said that, I am interested to see that someone diagnosed with >> "severe" preeclampsia was managed over a 3 day period. My goal is to >> get those patients delivered within 24 hours of diagnosis. I >> understand that this was somewhat of a "soft" call, but once the >> diagnosis is on the chart.... >> >> Was a foley bulb considered? I have found that an excellent adjunct >> to cytotec, when there are too many contractions to give a 2nd dose. > >> > Paul, you are my knight in shining armor to reply to Bob. I did not > make the distinction between Pre-eclampsia and Gestational Hypertension > and Pregnancy Induced hypertension, since I never can get them straight, > and, most important in this case, *it didn't matter*. Bob, sorry to be > argumentative and not scientific, but in this case, you gotta be > practicing Ob--I think that all of us would agree that delivery was > warranted. > > With respect to using a foley, I didn't grow up using them, and thus, it > didn't hit my radar scope. I will think about it next time, but I'm not > sure that this woman would have tolerated it. Can you put it in a > closed cervix? Would you ever place an epidural first? > > Paul, I am not aware of there being an arbitrary time limit in severe > pre-eclampsia. A staged ripening/induction like this isn't so common > anymore, but still OK, I think. Obviously, had her pressures been bad, > requiring apressoline (they didn't), her output diminshed, or her labs > getting worse, then I would have been more anxious to section her. As > it was, I was ready to section her just to put us all out of our misery! > > I bet that her SGOT will go up post partum! > > Garry > > -- > Garry E. Siegel, M.D., F.A.C.O.G. > Roswell, GA > Private Practice we had occassion to use the foley ballon in residency. Seem to have good success, primarily with cervical dilation not effacement. However, use was put on hold because of a couple of significant intrauterine infections. Anyone else have this experience? -- ###################### Charlie Chambers Hood River, OR USA cchamber@alumni.rice.edu ###################### Next message: Dean Huffman: "Woman in coma delivers healthy baby" Previous message: Charlie Chambers: "Re: OB: Fun with preeclampsia--very long!" Maybe in reply to: Garry Siegel: "OB: Fun with preeclampsia--very long!" Next in thread: Steve & Eryl Raymond: "Re: OB: Fun with preeclampsia--very long!"

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 04:49:24 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.