Re: OB: Fun with preeclampsia--very long!

From: D. Ashley Hill, MD (dahmd@cfl.rr.com)
Mon Jul 30 20:32:19 2001


At Mon, 30 Jul 2001, Garry Siegel wrote: >
>Ashley:
>
>She delivered vaginally!

Sorry, Garry. I thought I read in one of the 30 or so posts that she delivered by c/s. My bad.

>Given what you know (please read my original post, if needed, and add in
>no protein), would you really have sat on her for 6 hours--primip at
>term, elevated BPs by virtue of diastolics and 30/15 change (yes, we
>don't use it), creatinine of 1.1, platelets of 95K with normal platelets
>twice in pregnancy?

Again, I have no problem with your management, and in fact have seen a number of similar patients induced at our institution. Most of our patients would opt for induction, although a few would not, especially if they had an unripe cervix. My main point is that Bob Woolley had valid questions to you and the list about her diagnosis at the time of induction. I have seen well-known MFM attendings in residency produce a verbal colostomy for residents who induced patients without a "precise" diagnosis. I think it's helpful to discuss challenging cases on the list, and would like to add a "thank you" to you, and others, for posting cases for discussion (not that there is sometimes negative reinforcement for doing so)! Best wishes,

DAH

--
D. Ashley Hill, MD
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital Family Practice Residency
Orlando, Florida




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