Re: IUFD @ 35 weeks

From: art fougner, md (evsono@pipeline.com)
Fri May 30 07:19:53 2003

totally agree with steve's brilliant tip - when a long closed cervix remains long and closed after prostaglandins depite adequate contractions - make sure you double check the location of the fetus. When something is wrong, there is usually a reason.

art

At Thu, 29 May 2003, Steve Raymond wrote: >
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>
>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:
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> face="arial,helvetica"><font size="2" family="SANSSERIF" face="Arial"
> lang="0">
> 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
>

--
art fougner, md
ich bin ein New Yorker



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