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Re: Checking cervices at termFrom: Efrain Ramirez (eramirezt@coqui.net)Mon Feb 27 16:47:03 2006
At Mon, 27 Feb 2006, Dr Eberhard Lisse wrote: > >on 2/27/06 8:27 PM Garry E. Siegel, M.D. said the following: >> I check because: >> >> 1. Many patients want me to/are used to it. If they don't want me to, >> I don't unless overdue. > >Crap! > >> 2. Nice to know that they're vertex, although this is not perfect, and >> yes, midwives, the cervical exam is done in concert with Leopold's. > >Nonsense, Ultrasound does exist. And the vertex of Wednesday last week >in the G4P3 turned out to be a breech today. > >> 3. Nice to know what their "baseline" is when the primigravida calls >> after hours with few contractions. The one who was 3/90% might go to L >> and D; the long/closed one would be encouraged to wait longer. > >Well, my patients go to L&D when they are in active labour. > >> I am AMAZED at home many people kind so many reasons NOT to check a >> cervix. For instance, one of our CNMs saw someone with "a few >> Braxton-Hicks) at 30 weeks, who had been bleeding intermittently from a >> polyp. She also had a retroplacental bleed at 15 weeks. Long story >> short, she delivered a week later. Now, who knows if a cervical exam >> might have detected anything, but I submit that it MIGHT have helped, >> and would have been unlikely to have hurt her situation. Again, when in >> doubt, take a history, review the chart, and do the examination! > >I really am amazed at your prowess to diagnose retroplacental bleeds >with a vaginal examination. And to exclude placenta previa. > >el I have never been sorry for doing a pelvic examination - that's about 33 years of doing them.. Ef
-- “ The greatest obstacle to knowledge is not ignorance, it is the illusion of knowledge.” Daniel J. Boorstin - Historian
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