Re: Emporia ---> Process errors
From: Anna Meenan, MD (annam@uic.edu)
Tue Dec 7 15:32:05 2004
Other factors I have seen play into this: Length of labor...was it a
failed 3-day induction? Mom is EXHAUSTED (and most likely starved
besides) Conditions at home (four or five other screaming kids and a
husband who is worse than useless, and/or a M-I-L who jumps on Mom's
case over everything)? Fear of being left alone to take care of baby,
especially first baby, especially if baby had any problems.
I personally can't imagine why anyone who felt otherwise reasonably well
would willingly stay in the hospital, so I assume that anyone who is not
willing to go home when we expect they should be does not feel well or
has other issues.
--
Anna Meenan, MD
At Tue, 7 Dec 2004, Garry E. Siegel, M.D. wrote:
>
> It may related to time of delivery, parity, inherent patient
>factors (i.e. good or bad protoplasm), as well as their expectations.
>All of those are hard to quantitate and set up rules,
>
>Garry
>
>At Tue, 7 Dec 2004, Myer Bornstein wrote:
>>
>>Glen
>>In Massachusetts the law on the books is the patients can stay up to 4 days
>>after C/S/ I use to send my patients home in 48-72 hours and offered that
>>to the patients, most elect to stay 96 hours
>>
>>--
>>Myer S. Bornstein, MD, MMM, FACOG, FACPE, CPE
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod
>>Darryl G MAJ 48 MDOS/SGOBO
>>Sent: Tuesday, December 07, 2004 7:58 AM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: Emporia ---> Process errors
>>
>> At a recent medmal conference I attended the plaintiff's lawyers
>>stated that when there are risk factors for SD, such as excessive
>>maternal weight gain, suspected macrosomia, diabetes, or protracted
>>labor, then you should discuss this with the patient and "offer her a
>>c/section to avoid shoulder dystocia." On the one hand, some would
>>avoid and operative vaginal delivery if such risk factors exist, but I
>>wonder what this line of thinking would do to the national c/section
>>rate.
>>
>> Ashley
>>
>>Sort of off topic, but I recently looked over an article about the
>>rising csection rate and specifically looking at the effects of this on
>>LDRP numbers. I was amazed to see that they were using as their
>>assumption that csections stayed an average of nearly 4 days!
>>
>>I'm curious how long others keep the scheduled csections. I have only
>>had a handful in the last three years stay longer than 48 hours. I
>>can't imagine keeping a section for longer than three days baring
>>complications.
>>
>>Glen
>>
>>D. Glen Elrod, Maj USAF, MC
>>Obstetrician/Gynecologist
>>Maternal Child Flight
>>48 MDOS/SGOBO
>>UNIT 5210 Box 23
>>APO, AE 09464
>>DSN (314) 226-8334
>>Comm 01638-52-8334
>>
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>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
