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Re: Post dates pregnancy From: Ronald Ainsworth (ainsron@sbcglobal.net) Sat Mar 31 09:15:58 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: Post dates pregnancy" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Post dates pregnancy" Maybe in reply to: fbassani@brmc.com: "Post dates pregnancy" Next in thread: art fougner, md: "Re: Post dates pregnancy" I agree with Garry, I would at least do a CST and suggest C/S as a more reasonable option than induction with a unripe cervix. >----- Original Message ---- From: "Garry E. Siegel, M.D." <garrys@mindspring.com> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> Sent: Saturday, March 31, 2007 7:34:55 AM Subject: Re: Post dates pregnancy 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 Next message: art fougner, md: "Re: Post dates pregnancy" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Post dates pregnancy" Maybe in reply to: fbassani@brmc.com: "Post dates pregnancy" Next in thread: art fougner, md: "Re: Post dates pregnancy"

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