Re: 41 week Induction

From: Dr Eberhard Lisse (el@lisse.NA)
Fri Dec 2 22:09:01 2005


Either one has an indication for an induction, or not.

There is nothing in your mail about indication actually, 41 weeks can mean 40 + 1 in fact. How sure are you, are they, is she about her dates. How reliable is the sonographer, given that dating would be difficult in a very obse woman. She might just not be ready...

Or is the indications that she walked into the hospital?

Anyway, given that there was/is an indication for induction then after 24 hours it must be considered a failure and a vaginal bypass operation must be done.

greetings, el

Andrew Folley wrote: > Midwives are inducing 41 week primip tonight. this is her second or
> third day of induction with cytotec and cervidil at night. Remains
> closed long vertex. I am involved tonight as the 24 hour in house doc.
> To complicate matters the patient weighs a wopping 326 pounds.
>
> If she were my patient in private practice I probably would send her
> home and monitor closely and wait for labor to start and pray tha one of
> my partners would be on call when she comes back in labor.
>
> I am going to check her for the first time in a few hours I am thinking
> laminaria or AROM ASAP and foley catheter ripening. I don't mind doing
> the c-section but I just see the potential for post op problems with
> her. I would like to maximize her chances for a vaginal birth. Please
> give me some ideas. andy





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