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Re: OB: Polyhydramnios caseFrom: RModugno@aol.comWed Aug 11 06:57:16 2004
In a message dated 8/10/2004 8:16:25 PM Eastern Standard Time, garrys@mindspring.com writes: 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 Therapeutic amniocentesis. Robert Modugno MD MBA FACOG Marietta, GA http://www.novaobgyn.yourmd.com
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