Re: AMOL
From: Efrain Ramirez (eramirez@icepr.com)
Wed Apr 10 06:58:02 2002
I induce with Cytotec or Prostin gel , use pitocin a lot - start
antibiotics earlier - I do like Rich --I do not wait for signs of
infection - 18 hours is a good number -
At Wed, 10 Apr 2002, ainsron@msn.com wrote:
>
>If you follow the CDC guidelines and choose to culture all, then GBS
>negative patients should not be treated prophylactically just because
>they cross a magic time line. You should treat them only if they show
>signs of infection. If you follow the CDC guidelines and choose not
>culture or if a patient is GBS unknown, then patients should be treated
>by risk factors, such as: less than 37 wks, ROM >18 hours... or if
>signs of infection, which is no longer prophylactic.
>
>>I had this conversation with Carol Baker from Baylor, the "Group B. Strep"
>>maven. She felt that since the usual hospital setting may take up to 1-2
>>hours to start antibiotics after order is submitted, she recommends ordering
>>them 12-14 hours after rupture of membranes. I was also under the impression
>>that when a patient has been ruptured for 18 hours (18 hours after a
>>cervical exam with rupture) antibiotics should be started to decrease the
>>risk of chorioamnionitis.
>>
>>--
>>Richard Chudacoff, MD, FACOG
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of
>>ainsron@sbcglobal.net
>>Sent: Tuesday, April 09, 2002 7:52 PM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: AMOL
>>
>>I would only use antibiotics if GBS+ or treat if signs of infection.
>>
>>>No protocol, but I do like aggressive Pitocin and start antibiotics about
>>>12-14 hours after ROM. I don't use 12 hours, too boilerplate. Primary
>>>c-section rate is less than 7%, so I guess it works.
>>>
>>>--
>>>Richard Chudacoff, MD, FACOG
>>>
>>>-----Original Message-----
>>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Bernard
>>>Cristalli
>>>Sent: Tuesday, April 09, 2002 3:46 PM
>>>To: Multiple recipients of list OB-GYN-L
>>>Subject: Re: AMOL
>>>
>>>So OK for AMOL with me, except the 12 hours dead-line.
>>>
>>>--
>>>Bernard Cristalli MD AMACOG
>>>AIHP - ACCA
>>>Paris France
>>>Bernard.Cristalli@CliniquedelEssonne.fr
>>>http://www.CliniquedelEssonne.fr
>>>http://www.obgyn.net/corresp/cristalli.htm
>>>http://www.gyneweb.fr
>>>'64 Mk2 3.8
>>>
>>>De : PELLIS45@aol.com
>>>Répondre à : ob-gyn-l@obgyn.net
>>>Date : Tue, 9 Apr 2002 15:35:08 -0500
>>>À : Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.medispecialty.com>
>>>Objet : Re: AMOL
>>>
>>>In a message dated 4/9/02 4:23:14 PM Eastern Daylight Time,
>>>bcrist@club-internet.fr writes:
>>>
>>>What do you mean by AMOL?
>>>
>>>......active management of labor. Strict adherence to the Friedman Curve,
>>>pit for induction and augmentation, routine epidural, deliver in 12 hours
>>>whether vaginally or section. Started in Ireland........thanks for
>>>replying.
>>>
>--
>Ronald E. Ainsworth, MD
>
--
"Life is neither the notes nor the silence between the notes, but the music that
arises out of sound and silence felt as a living whole. Stop choosing...between
chaos and order, and live at the boundary between them, where rest and action
move together..." David Whyte
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