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Re: Interesting case. From: art fougner, md (evsono@pipeline.com) Sun Mar 13 12:51:23 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Brian Fox: "Re: Interesting OB case" Previous message: art fougner, md: "Re: Ultrasound as part of the normal exam" In reply to: Anna Meenan, MD: "Re: Interesting case." Next in thread: DoctorJoe@aol.com: "Re: Interesting case." No Anna - your instincts are good - there's not much else to offer at 18+ wks gestation. moreover, is the referral center committed to hospitalization for the duration? if so - this woman, given her previous history, will doubtless sign out if and when the spirit moves her. and if not, where will this woman go after discharge? would she report regularly for outpatient assessment? surely these issues need addressing prior to any referral - no matter how much better the chart appears. art At Sun, 13 Mar 2005, Anna Meenan, MD wrote: > >OK, I know I'm just a lowly FP, but I'm just curious as to what a >perinatologist and a level 3 center are gonna do for these kids at this >stage of gestation. I'm guessing she's gonna get bedrest and probably >antibiotics and serial growth scans. At least until the kids reach a >viable stage, which is probably at least a month or more from now, >wouldn't it make sense to keep her there, near her family (if she has >one)? Give the bag a chance to seal over if it's gonna, and then >transport to a level 3 center might be safer, once it looks like it >might be possible to keep them in utero. >Again, I am an FP, and I would certainly call the perinatologist on a >case like this (who is fortunately just 3 miles across town), but if we >were pondering sending a previable gestation 220 miles away, I would >want to know what he's gonna do that couldn't be done by the local guys, >at least until the kids become potential NICU patients. > >Just my humble opinion, and I certainly could be wrong. > >-- > Anna Meenan, MD, FAAFP > >At Sun, 13 Mar 2005, DoctorJoe@aol.com wrote: >> >>In a message dated 3/13/05 1:32:17 AM, GIN11153@aol.com writes: >> >>> Transfer her to the referral Level 3 hospital? She needs a perinatologist >>> to try to save the babies >>> >>I agree. >> >>Joe P. >> >>P.S. But, of course, it's up to the mama what to do. > -- art fougner, md "If you don't know where you are going, you will wind up somewhere else." Lawrence Peter Berra Next message: Brian Fox: "Re: Interesting OB case" Previous message: art fougner, md: "Re: Ultrasound as part of the normal exam" In reply to: Anna Meenan, MD: "Re: Interesting case." Next in thread: DoctorJoe@aol.com: "Re: Interesting case."

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