Re: OB: Polyhydramnios case
From: Efrain Ramirez (eramirezt@coqui.net)
Tue Aug 10 20:48:29 2004
No sweat..
>At Tue, 10 Aug 2004, Garry E. Siegel, M.D. wrote:
>
>I thought about therapeutic amnio but felt that a bit extreme.
>Furthermore, as with AROM, decompression might lead to an abruption.
>
>Normal fetus and EFW on scan at MFM around a week ago; sorry that I
>omitted that detail.
>
>I chose to put an epidural in first, once it was obvious she would
>deliver during this admission. Even if a cord prolapsed with AROM or
>SROM, at least we might be able to use the epidural. The L and D OR,
>etc., were ready for a section.
>
>After the epidural, a foley. Repeat exam--5 to 6/50/-2 vertex nicely
>applied. I then ruptured membranes, began Pitocin, and delivered
>vaginally and left by 7 PM :). Mom and baby happy and well.
>
>Garry
>
>At Tue, 10 Aug 2004, Richard Chudacoff, MD wrote:
>>
>>Before anything I would place the epidural, unless you feel you would be
>>more likely to crash her and use an ET tube
>>
>>--
>>Richard Chudacoff, MD
>>
>>A countryman between two lawyers is like a fish between two cats.
>>
>>Benjamin Franklin
>>
>>Heaven grant that the burden you carry may have as easy an exit as it had an
>>entrance.
>>[Prayer To A Pregnant Woman]
>>-Desiderius Erasmus
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Efrain
>>Ramirez
>>Sent: Tuesday, August 10, 2004 5:53 PM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: OB: Polyhydramnios case
>>
>>#4 notify OR - possible cord prolapse - guess we are dealing with
>>"normal" EFW.
>>
>>Good luck..
>>
>>At Tue, 10 Aug 2004, Garry E. Siegel, M.D. wrote:
>>>
>>>34 YO P1102 at 36+2 was found to have idiopathic polyhydramnios at 34
>>>weeks. Normal repeat glucose screen, normal level 2 scan.
>>>
>>>Presents at 0200 with mild contractions, cervix by RN 3-4/50/high; was
>>>2/50/high in the office a few days beforehand.
>>>
>>>0800--FH 41 cm., cervix 3-4/50/very high such that I only felt the
>>>amniotic membrane and no presenting part. Vertex by ultrasound,
>>>contractions mild but steady and getting a bit worse.
>>>
>>>1300--5-6/50/very high but felt a hand flit by. Contractions about the
>>>same.
>>>
>>>What are your concerns? How would you handle this? Any interventions to
>>>make?
>>>
>>>Choices:
>>>1. Do nothing.
>>>2. Section now.
>>>3. Pitocin
>>>4. Careful ROM, say with Pudendal needle.
>>>5. Place epidural--then could do nothing, start Pitocin, or AROM, or
>>>reassess.
>>>
>>>Garry
>>>
>>>--
>>>Garry E. Siegel, M.D.
>>>Private Practice
>>>Roswell, GA
>>>
>>--
>>"The opposite of a correct statement is a false statement.
>>But the opposite of a profound truth may well be another profound truth."
>>
>>Niels Bohr (1885 - 1962)
>>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
--
"The opposite of a correct statement is a false statement.
But the opposite of a profound truth may well be another profound truth."
Niels Bohr (1885 - 1962)
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