Re: IUFD @ 35 weeks

From: Steve Raymond (eryl@intekom.co.za)
Thu May 29 15:49:42 2003


<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"> 1.  For 2nd trimester abortions you may need to give vaginal Cytotec 200mcg per dose, repeated 12hourly.
2.  We have found that there is a strong association between abdominal pregnancy and failure to be induced with Cytotec.  Not sure what your incidence of abdominal (extra-uterine) pregnancy is but in our environment that would be the first thing we would exclude when faced with a failed attempt at induction of midtrimester abortion.  I guess that there have been several first class sonographers see this patient and that none of them is going to miss an extra-uterine pregnancy!!
Steve

Len2976@aol.com wrote:

After counseling patient was admitted by the CNM on call (consulted with OB) for IOL.  Cx was unfavorable.  Patient now has had cytotec 100 mcg p.o. q 3 hours  (7 doses) with no effects yet--started to ask about C/S, which we discouraged. 

Questions for group:

1. Should management after bleeding incident 1 month ago have been managed differently?  weeking BPPs, NSTs, etc???

2. Suggestions for IP management now.  I have found in the past with 2nd trimester IUFDs that vaginal cytotec seems for effective than p.o.  Comments?  Dosage?

Thanks for the advice..

Lenora McCall, CNM

--
S.H. Raymond FRCOG
Principal Specialist
Department of Obstetrics & Gynaecology
Empangeni Hospital
Private Bag X20005
Empangeni
SOUTH AFRICA 3880

Phone: (+27)-35-9028560
Fax: (+27)-35-7922596





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