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Ingrid Gold, CNM
Phoenix
> ----- Original Message -----
From: David Rivera
To: Multiple recipients of list OB-GYN-L
Sent: Saturday, June 11, 2005 1:35 PM
Subject: Re: Tocolytics, was MgSO4 questions
Reminds me of a JAMA article 20 years ago questioning the wisdom of pre-op labs in healthy patients. Most of the time the labs were normal. When they weren't they were usually dismissed with a shrug.
Ingrid Gold <igold@cox.net> wrote:
I always hate to inherit a patient who has been on terb or something else. Or, if she knows someone who has. She thinks I'm not doing all I can if I don't feel it is necessary to continue/start. I hate doing things that I know don't work.
Ingrid Gold, CNM
Phoenix
> ----- Original Message -----
From: David Rivera
To: Multiple recipients of list OB-GYN-L
Sent: Saturday, June 11, 2005 9:17 AM
Subject: Re: MgSO4 questions
If uterine contractions have been documented throughout gestation, then why is this "Threatened Preterm Labor"?
I remember one lady who contracted until we stopped her tocolytics, then she stopped contraction. I also worked with an L&D nurse who was 8 months and used to say of primips who showed up smiling, saying "I'm in labor"
"If she isn't contracting as much as I am, she can't stay!"
All those medications are as effective as placebo. More often than not they are used to placate the nursing staff.
DAR
"R. Daniel Braun" <rd.braun@gmail.com> wrote:
No, actually that is "Threatened Preterm Labor" and is the only thing that any of our medications MIGHT do anything to. Once you have "Labor", nothing does anything. Interestingly there are multiple studies out there showing that all of the medications you mentioned are as effective as every other one of them. Nifedipine has the lowest incidence of side effects. BTW, none of those studies compared anything against PLACEBO. Personally, I think that none of them are any better than placebo. Again that is my own humble opinion and no better than yours that MgSO4 is the best.
Dan
On 6/10/05, David Rivera <cuurmudgeon@sbcglobal.net> wrote:
"Tocolysis works best in women who don't need it."
If someone is really in preterm labor, use Mag. You are wasting time with terbutaline and nifedipine. Sadly, many like to shoot at any thing that contracts and that drives me nuts. I was taught preterm labor is "contractions accompanied by dilation and effacement" not "contractions driving the patient and the nurses nuts."
Andrew Folley <agfolley@hotmail.com> wrote:
What is the scoop with Mg SO4 and premature labor tocolysis? I can not tell
from the literatureir if it is still worthwhile now as a tocolytic?? Is it
dangerous for the baby (increased neonatal deaths for preemis 700 gr-1250
grams in moms getting more than 48 grams Mg). Are we just using it for 48
hours to get the steroids in and then not give it any longer?(ie what about
on 5th hospital day when she starts contracting again? Is everyone stil?
using it as first line and for only 48 hours?andrew
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R. Daniel Braun
Kinky for Governor
