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Re: Fetal demise 31 wks aburption. From: Andrew Folley (agfolley@hotmail.com) Sat Nov 17 09:02:11 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: AllanHo@aol.com: "Re: Calif. Bar Board Members Butt Heads on Malpractice Insurance Disclosure" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: 2am roundtable discussions" In reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Fetal demise 31 wks aburption." No question in my mind based on evidence you provided: Arom and induction and vaginal delivery. C-section totally out of question at this point. Also rule out HELLP as etiology of abruption. consider leyden factor V as well. Treat DIC as appropriate with Fresh Frozen Plasma and Cryoprecipitate etc. agf> Date: Wed, 14 Nov 2007 05:43:56 -0600> From: johnprov@sympatico.ca> To: ob-gyn-l@dns.obgyn.net> Subject: Fetal demise 31 wks aburption.> > 24 y.o. G3P1 prsents 6 hrs after severe onset lower abdominal pain baby> not moving for over 12 hrs. Upon admission to D.R. no fetal heart and> then fetal demise confirmed by beside U/S. This patient had a c-section> at 28 wks for first pregnancy for aburption, that baby is doing well.> Had a laproscope for pain last year showed significant scarring with> uterus stuck to anterior abdominal wall, no lysis of adhesions as tubes> actually looked healthy. Admission blood work Platlets 94,000 , hgb 98,> INR 1.1 PTT 37.; Cervix 1 cm 30% effaced, no bleeding intially but> definte bleeding after cervical exam. It's obvious she is having a> massive aburption and developing a D.I.C., so plan A do a repeat> c-section in view of developing DIC and probable difficult c-section> which can easily end up in a hyst or massive post op pelvic hemotoma.> Plan B attempt vaginal delievery. Anyone have any pearls of wisdom to> offer.> > --> Take care, John _________________________________________________________________ Your smile counts. The more smiles you share, the more we donate.=A0 Join i= _________________________________________________________________ n. http://www.windowslive.com/smile?ocid=TXT_TAGLM_Wave2_oprsmilewlhmtagline Next message: AllanHo@aol.com: "Re: Calif. Bar Board Members Butt Heads on Malpractice Insurance Disclosure" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: 2am roundtable discussions" In reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Fetal demise 31 wks aburption."

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