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Re: Post dates pregnancyFrom: fbassani@brmc.comSat Mar 31 08:42:01 2007
At Sat, 31 Mar 2007, Garry E. Siegel, M.D. wrote: > >Deliver her. > >Offer ripening with induction, realizing it really may not work due to >an unfavorable cervix and/or possible lack of fetal well-being. It also >would be very reasonable to section her without a trial of labor. > >While it is unlikely something is wrong, as you said, why wait for the >roof to fall in? > >Garry > >At Sat, 31 Mar 2007, fbassani@brmc.com wrote: >> >>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 > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > My contention exactly, but unfortunately I am not there! Its tough to leave the care of our pts with others. F Bassani
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