Re: April fools

From: R. Daniel Braun (rd.braun@gmail.com)
Mon Apr 2 13:44:02 2007


So why do the double set up ? You weren't going to find anything that would allow you to let her labor in your center. all the other people were still going to have all those other conflicts anyway, no matter what you found. In these times of doing elective C/S on demand, why delay things by doing a double set up when you are going to deliver abdominally anyway????

Dan

On 4/2/07, Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. < johnprov@sympatico.ca> wrote: >
> At Mon, 2 Apr 2007, Danae Steele wrote:
> >
> >How about looking at the baby first before cutting? If the baby looks ok
> on the monitor, and if mom (a multip) has a cervix that has any dilation at
> all, rupture membranes. Then if its just a marginal abruption from the
> inferior placenta, the fetal head will likely tamponade the placenta and you
> can let her deliver vaginally.
> >
> > Danae
>
> Yes Part of the reasoning for the double setup, the exam showed her to
> be 1-2 cm dialated 80 % effaced and as expected by abdominal exam the
> head was unegaged, and indeed the placenta was at the edge of the the
> cervical os I could not rule out a vasa previa. Waiting for the head to
> tamponade the bleeding was a game of chicken I was not willing to play,
> even with out a vasa previa the bleeding could of still been partly from
> the fetus, 50-100 ml of baby bleeding can compromise baby very fast. I
> also had the anaesthist remind he he had to go do a perforated viscus at
> the main o.r. and Nicu standing by; in the end knowing the limits of
> what your center is capable of is also important, logistics.
>
> --
> Take care, John
>

--
R. Daniel Braun, MD  FACOG(L)  CMT
Professor Emeritus
Dept. of Obstetrics and Gynecology
Indiana U. School of Medicine

R. Daniel Braun

"The way to health is an aromatic bath and scented massage everyday". Hippocrates





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