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Larry R. Glazerman, MD
Ob-Gyn at Trexlertown, PC
larry.glazerman@lvh.com
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry
E. Siegel, M.D.
Sent: Thursday, March 18, 2004 10:06 PM
To: Multiple recipients of list OB-GYN-L
Subject: OB: 31 week IUFD
I only have partial information here, but would appreciate any input.
approx 30 YO P2002, 2 prior unknown sections, now 31 weeks presents for
a routine visit and found to have an IUFD, vertex, closed/thick cervix.
My partner has said she is not the best and the brightest, and her
understanding level (to him) was substandard.
She has been a bit haphazard in her prenatal care, missing appointments,
social trouble, etc. At around 11 to 14 weeks, she was in the hospital
for many days with GI trouble/?gallstones (I can't remember the
details). She mainly has been seen by one of my partners, who is less
experienced than me by over 15 years. This was around noon today.
He asked me about the patient, as I'm on call starting Friday for the
weekend, and I suggested that, if her cervix was poor (at the time we
talked, it hadn't been checked), that it might be best to sit tight a
few days rather than immediately deliver. I also pointed out that this
was no emergency medically, and perhaps the smartest thing that we could
do would be nothing. We discussed ripening and induction, and I vetoed
cytotec (2 prior unknown sections) and suggested cervidil and pitocin if
induction were chosen.
My partner called me around 7 PM from L and D, where she had gotten her
cervidil, wondering what we should do if she doesn't respond.
I suggested that we reassess her in the AM, and if her cervix is still
rock hard, to again consider NO action as the best course.
Any thoughts?
Garry
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Garry E. Siegel, M.D.
Private Practice
Roswell, GA
