Re: 34 week prom
From: R. Daniel Braun (rd.braun@gmail.com)
Fri Apr 8 10:57:13 2005
Regular contractions will suffice in this situation. Also onm
e can do speculum exams if really worried about it. but in this
situation, regular contractions would be a sign of infection an an
indication for delivery.
Dan
On Apr 8, 2005 8:11 AM, art fougner, md <evsono@pipeline.com> wrote:
> Dan ...
>
> in this setting, without digital exams ... please define labor.
>
> Art
>
> At Fri, 8 Apr 2005, R. Daniel Braun wrote:
> >
> >I would manage by doing
> >
> >1. NO digital vaginal exams,
> >2. Ampicillin
> >3. Steroids
> >4. Observation IN HOSPITAL until:
> > A. Reaches 37 weeks or
> > B. Shows signs of infection.
> >
> >My observation in addition to Temperature recording would include a
> >daily 10 min FHR strip for BASELINE FHR. The baseline FHR will
> >increase prior to most other signs of infection. Would also daily
> >palpate for tenderness. Labor in a patient with ROM may well be a sign
> >of infection and hence an indication for delivery.
> >
> >Dan
> >
> >On Apr 7, 2005 7:58 PM, Robert J. Carpenter, Jr. MD <zygote@icsi.net> wrote:
> >> Not if I have my say and nature is cooperative with no labor, no infection, etc.
> >>
> >> On 7 Apr 2005 at 12:20, Richard Chudacoff, MD wrote:
> >>
> >> > What did the MFMs want you to do? In one of my intuitions they want
> >> > them delivered at 34 weeks
> >> >
> >> > Richard Chudacoff, MD
> >> >
> >> > -----Original Message-----
> >> > From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
> >> > Andrew Folley Sent: Thursday, April 07, 2005 11:16 AM To: Multiple
> >> > recipients of list OB-GYN-L Subject: RE: 34 week prom
> >> >
> >> > Question: Had a patient show up last night G3P2 ruptured membranes 34
> >> > weeks
> >> >
> >> > 1 day. 2 prior c-sections. Not in Labor. What to do? She is vertex
> >> > fluid in vault sent for f-pole showed not mature. My plan was
> >> > steroids, tocolysis
> >> >
> >> > for 48 hours if necessary and repeat c-section in 48 hours.
> >> > Along with GBS prophylaxis. Some of our MFMs were not so happy with
> >> > the management plan. What ywoud you do???? andy
> >> >
> >> > >
> >> >
> >> > _________________________________________________________________
> >> >
> >> > _________________________________________________________________
> >>
> >> Robert J. Carpenter, Jr. MD
> >> 6624 Fannin, #2720
> >> St. Luke's Medical Tower
> >> Houston,TX 77030-2339
> >> 713-795-4600
> >>
> >--
> >R. Daniel Braun
> > Kinky for Governor
> >
>
> --
> art fougner, md
>
> "If you don't know where you are going, you will wind up somewhere else."
> Lawrence Peter Berra
>
--
R. Daniel Braun
Kinky for Governor
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