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Re: OB: Those crazy VBACs From: Andrew Folley (agfolley@hotmail.com) Fri Mar 4 17:08:26 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: OB: Those crazy VBACs" Previous message: Efrain Ramirez: "Re: Exam lights" In reply to: R. Daniel Braun: "Re: OB: Those crazy VBACs" Next in thread: Efrain Ramirez: "Re: OB: Those crazy VBACs" Reply: Efrain Ramirez: "Re: OB: Those crazy VBACs" Reply: Andrew Folley: "Re: OB: Advanced maternal Age" Dan uterus with inductin with pitocin or prostaglandins (25 per 1000 VBACs vs 5 per 1000 with spontaneous labor). Practically speaking I would break her bag of water and have her walk around for a few hours and induce with pitocin and internals If we are going to be purists... nsts twice a week and US for AFI and let her go through 42 weeks. Then induce with risks or offer section. andy >From: "R. Daniel Braun" <rd.braun@gmail.com> >Reply-To: ob-gyn-l@obgyn.net >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >Subject: Re: OB: Those crazy VBACs >Date: Thu, 3 Mar 2005 21:39:42 -0600 > >At 41 weeks the section rate gets to be nearly 40% if you induce and >about 43% if you just follow them with NST's. Several RCT's in the >literature showing that. Also a Meta-analysis by Hannah from Toronto. > >On Thu, 3 Mar 2005 20:31:51 -0600, Garry E. Siegel, M.D. ><garrys@mindspring.com> wrote: > > 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 > > > >-- >R. Daniel Braun > Kinky for Governor Next message: Efrain Ramirez: "Re: OB: Those crazy VBACs" Previous message: Efrain Ramirez: "Re: Exam lights" In reply to: R. Daniel Braun: "Re: OB: Those crazy VBACs" Next in thread: Efrain Ramirez: "Re: OB: Those crazy VBACs" Reply: Efrain Ramirez: "Re: OB: Those crazy VBACs" Reply: Andrew Folley: "Re: OB: Advanced maternal Age"

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