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Re: Twins incompetent cervix Help From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com) Mon Jan 17 07:27:41 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Chudacoff, MD: "Re: 32 week PROM Recent Herpes outbreak Help" Previous message: Andrew: "32 week PROM Recent Herpes outbreak Help" In reply to: RModugno@aol.com: "Re: Twins incompetent cervix Help" Interestingly enough, my last two 'preterm, positive fetal fibronectin' patients, diagnosed at or before 32 weeks EGA, both delivered after 37 weeks using hydroxyprogesterone cyproate. I think I'd tap her to rule out infection, and if negative, then use it. I'd also start steroids at 24 weeks with another dose around 28-30 weeks if she gets that far. -- Richard Chudacoff, MD _____ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of RModugno@aol.com Sent: Sunday, January 16, 2005 12:41 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Twins incompetent cervix Help In a message dated 1/16/2005 12:18:50 PM Eastern Standard Time, agfolley@hotmail.com writes: Need advice on handling G1P0 twins 22.5 weeks wih incompetent cervix Presents to office with discharge and cervix 3 com 80% with bow present but not "hourglassing". I am opting for cerclage, MFM consultant leaning toward bedrest expectant management. I started her on indomethacin 25 q 6 and IV antibiotics (WBC 16000 and CRP elevated. what does the group think??andrew There is no "right" answer here. Does she have any other predisposing factors for cervical insufficiency?History of uterine contractions? It's either one or the other or a combination of the two?I would tend toward cerclage. The patient needs to be appraised of the difficulties and controversies involved with her management, possible chorio, pprom, blah...blah...blah... Would anyone use hydroxyprogesterone? Robert Modugno MD MBA FACOG Marietta, GA http://www.novaobgyn.yourmd.com Next message: Richard Chudacoff, MD: "Re: 32 week PROM Recent Herpes outbreak Help" Previous message: Andrew: "32 week PROM Recent Herpes outbreak Help" In reply to: RModugno@aol.com: "Re: Twins incompetent cervix Help"

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