Re: Difficult case
From: Andrew Folley (agfolley@hotmail.com)
Wed May 16 08:02:46 2007
Recommendation for delviery based on centralization of flow on doppler.
Normal "nonreactive" tracing for a 27 weeker.
>From: evsono@pipeline.com (art fougner, md)
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: Re: Difficult case
>Date: Tue, 15 May 2007 07:20:34 -0500
>
>What was your consultant's rationale? And please define "normal
>nonreactive."
>
>Art
>
>At Mon, 14 May 2007, Andrew Folley wrote:
> >
> >26 yo WF G3P2 at 26 weeks presents to triage last friday evening with
> >bleeding. No prenatal care. This is her third pregnancy with 8 pound
>baby
> >delivered vaginally 6 years ago and 5 pound baby delivered at 36 weeks
> >c-section for breech 15 months ago. Ultrasound on admission shows low
>lying
> >placenta possible marginal previa and some possibility of abruption. US
>also
> >reveals oligohydramnios with AFI 3 cm. Ultrasound plots the infant at 27
> >weeks 5 days. Weight is 2 poiunds, vertex and 47% for growth; no
>anomalies
> >seen. She receives steroids Friday and Saturday. FHTs are 140s and
> >"normal non reactive for 26 weeker" no variables seen. Patient remains
> >stable Sunday and today bleeding about one pad per day and no pain or
> >contractions. Continuous EFM show no changes in tracing. MFM consultant
> >recommends she be delivered soon ie next 24 hours by C-section. Why????
> >
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>art fougner, md
>"May The Wings of Liberty Never Lose a Feather." - Jack Burton
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