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Re: Those crazy VBACsFrom: ainsron (ainsron@sbcglobal.net)Fri Mar 4 13:09:26 2005
You're still letting CNMs follow VBACs? If I were allowing VBACs, I would do a Sonogram as well for AFI and EFW. I wouldn't induce with pitocin, but might consider amniotomy at this point, with the understanding that she will need a C/S if no progressive spontaneous labor. Otherwise, repeat NST in 3d and deliver by 42 weeks by C/S or amniotomy induction. Ronald E. Ainsworth -----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 03, 2005 6:32 PM To: Multiple recipients of list OB-GYN-L Subject: OB: Those crazy VBACs I won't have the 100% right, but good enough for fun. 36 YO P3003, CNM patient, in the office at 41w3d for NST, which is reactive, on Wednesday. 1st delivery--LTC/S for pushing, OP. Forgot the weight--sorry. 2 VBACs afterwards--easy 8-ish pounds. Now 41w3d, 2-3 cm./70%. I happened to see this chart in the door and reviewed, and felt obligated to put in my $0.02 to the CNM and have a face to face chat witht the patient. What would you tell the patient? BTW, she said she's always late and her kids have always been OK. Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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