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Re: What would you do? From: zygote@icsi.net Thu Dec 28 21:39:26 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Bernard Cristalli: "Re: What would you do?" Previous message: Henry Gregor: "Re: Pagers (From Today's NY Times)" In reply to: Dr Eberhard Lisse: "What would you do?" Next in thread: D. Ashley Hill: "Re: Ob: Suspected nephrolithiasis" Having read the other posts before replying one could consider the following: 1. If iv in place then Dexamethasone for lung maturity - a dose will not cause injury and reversing anticaogulation to do amnio is not my cup of tea. 2. I would do repeat C/S at 38-39 weeks after appropriate reversal or cessation of heparin 3. Heparin restart at 12h post procedure. 4. If VBAC considered the duration of cessation of anticoagulation will be prolonged and increase risk for another clot. (What degree - no idea) 5. If catastrophic rupture occurs, you now have potential for hysterectomy and with renewed anticoagulation, the increased risk for major intrabd bleed. 6. I personally do not labor someone with 2 prior C/S though I am sure some do. Thanks El RJC On 28 Dec 2006 at 3:51, Dr Eberhard Lisse wrote: Subject: What would you do? > Hi, > > I have inherited a patient of my colleague who is away over the holidays, > > Two previous Caesars, pulmonary embolus in February 2006, went off the > pill, and duly fell pregnant at now 36 weeks, to get another pulmonary > embolus yesterday. Is now in ICU but clinically well, not dyspnoeic at > all, in the care of an Internist on Clexane. > > I have asked for an Ultrasound for dates (for all it is worth) and fetal > wellbeing, and ordered serial CTGs. > > I forgot to mention that she is a colleague (Pediatrician). > > greetings, el > Robert J. Carpenter, Jr. MD 6624 Fannin, #2720 Houston, TX 77030 (O) 713-795-4600 (F) 713-795-4422 "Life is difficult" The Road Less Travelled by Scott Peck Next message: Bernard Cristalli: "Re: What would you do?" Previous message: Henry Gregor: "Re: Pagers (From Today's NY Times)" In reply to: Dr Eberhard Lisse: "What would you do?" Next in thread: D. Ashley Hill: "Re: Ob: Suspected nephrolithiasis"

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