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Post dates pregnancyFrom: fbassani@brmc.comSat Mar 31 08:27:22 2007
Question: how would any of you manage the following case; A 23 yo Primagravida at 40 weeks and 3 days, with excellent 1st trimester dating sonography, presents to the office complaining of decreased fetal movement. Cervical exam at that time is closed high, and unengaged, balottable, yet vertex. NST shows two late decelerations at first that respond to position change. A vibroacustic stimulator is used and a reactive NST is obtained. BPP was 8/10 prior to reactive nst. My patient was sent home with continued expectant management, by a locum physician. I contend that "hat are we waiting for?" We have a primagravida with Post dates, questionable antenatal testing, decreased fetal movement, unengaged head at term, and the need for vibroacustic stimulation to obtain a reactive tracing. Does the roof need to fall in on someone to tell them to get out? I would love some comments and/or thoughts on this. I am on vacation, and the patient is still pregnant! Dr Bassani PA
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