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Re: new ACOG Practice Bulletin No. 33 Preeeeclampsia From: art fougner, md (evsono@pipeline.com) Tue Jan 8 20:01:57 2002 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: Polyhydramnios, induction" Previous message: jafar6: "Re: new ACOG Practice Bulletin No. 33 Preeeeclampsia" In reply to: jafar6: "Re: new ACOG Practice Bulletin No. 33 Preeeeclampsia" Next in thread: Terrence Jones: "Re: new ACOG Practice Bulletin No. 33 Preeeeclampsia" Richard - you beat me to the punch on this one - the key is definitely remote from term - tertiary especially for neonatal care for the very low birthweight baby. reminds me of the time a patient with severe pre-eclampsia and triplets was admitted to a primary level facility while i was on third year rotation. while the nursery had ventilators, they had only two. so the pediatric nurse clinician - quite perturbed that the private attending was not interested in maternal transport - asked the attending point blank which newborn he would wish to sacrifice should all three require ventilator support. while i have oft been a critic of ACOG the safety of both the maternal and fetal patients should be our primary goal - all else including turf should be secondary. if we each can truthfully say that our hospital unit is equally equipped to care for the special needs of these patients, then no worries. if not - transport of the stable mom would seem appropriate where feasible. just my opinion - i could be wrong. art At Tue, 8 Jan 2002, Richard Meisel wrote: > >On Tuesday, January 8, 2002, at 07:43 PM, Joe Cutchin wrote: > >> "The management of a woman with severe pre-eclampsia remote from term is >> best accomplished in a tertiary care setting or in consultation with an >> obstetrician-gynecologist with training,experience,and demonstrated >> competence in the management of high-risk pregnancies such as a >> maternal-fetal medicine subspecialist".I certainly don't disagree that >> this is the best of all worlds but why do we set ourselves up for the >> plantiff's bar?Has the college defined what is a tertiary obstetrical >> unit? All severe preeclampsia patients must be transferred or the burden >> shifts to the person in the trench ? Consultation? Telephone? Physically >> present?Why do we do this to ourselves?So my College is hinting to >> everyone that as an ordinary obstetrician I am not able to take care of >> severe preeclampsia?Where is the real world here? >> >The key phrase is remote from term. This is almost a verbatim quote from >one of Sabai papers. Personally I don't see how this can bother anyone. >If you have a severe PIH and you don't have the support to take care of >the problem of course you should ship the mother. > >Best Wishes, >R L Meisel, MD -- art fougner, md ich bin ein New Yorker Next message: art fougner, md: "Re: Polyhydramnios, induction" Previous message: jafar6: "Re: new ACOG Practice Bulletin No. 33 Preeeeclampsia" In reply to: jafar6: "Re: new ACOG Practice Bulletin No. 33 Preeeeclampsia" Next in thread: Terrence Jones: "Re: new ACOG Practice Bulletin No. 33 Preeeeclampsia"

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