Re: 41 week Induction

From: art fougner, md (evsono@pipeline.com)
Sun Dec 4 08:28:29 2005


>From Cochrane:

Routine early pregnancy ultrasound examination and subsequent adjustment of delivery date appear to reduce the incidence of post-term pregnancy. Routine induction of labour after 41 weeks gestation appears to reduce perinatal mortality. There is not enough evidence to evaluate the effects of breast and nipple stimulation, or tests of fetal wellbeing.

Art

At Sun, 4 Dec 2005, Efrain Ramirez wrote: >
>One of the reasons, besides convenience (for the doctor and the
>patient), is fear of litigation. When a patient is on her 40th week a
>typical conversation with the patient AND her mother AND her mother in
>law would bring up the bad outcomes they have heard because of “waiting
>to long” – “fue un parto seco” – it was a “dry labor” - almost no
>stories on “bad” outcomes with inductions -- after a lot of explaining –
>one more week is accepted – after that… and specially in a multip. –
>and with the available data – the question is …why NOT go ahead and
>induce? – In the people’s mind – keep on waiting is “doing nothing” –
>--inducing one is "trying to avoid bad consequences" – in the event of
>an emergency C/S due to “failed induction”, failure to progress or
>“intolerance to labor” – the Doc did everything he could … that’s the
>way it is – at least down here….
>
>Ef
>
>At Sun, 04 Dec 2005, Dr Eberhard Lisse wrote:
>>
>>Efrain Ramirez wrote:
>>> 41 weeks to me is 40 completed weeks - not 40 + 1 day ..
>>
>>40 + 1 is 40 completed weeks plus one day = 41 weeks.
>>
>>> 41 weeks is a reasonable gestational age for induction - (one can wait
>>> 2-3 more days on a primip with good BPP) - with adequate dates and/or
>>> ultrasound..
>>
>>Why is is that roughly 100% of patients walking into some hospitals in
>>the US are induced with no discernible imprevement in outcome?
>>
>>el
>
>--
>Ability is what you're capable of doing.
>Motivation determines what you do.
>Attitude determines how well you do it.
>
> - Lou Holtz
>
> ~walt whitman~
>

--
art fougner, md

"I knew I was going to take the wrong train, so I left early." Lawrence Peter Berra





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