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Re: No Posts! From: ainsron (ainsron@sbcglobal.net) Thu Nov 29 14:44:09 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: sharon@methadonesupport.org: "Re: Methadone Pregnancy Info" Previous message: Dr Eberhard W Lisse: "Re: Prophy ABX for Elective C/S was Re: No Posts!" In reply to: Andrew Folley: "Re: No Posts!" Next in thread: Garry E. Siegel, M.D.: "Re: No Posts!" http://www.cdc.gov/groupbstrep/hospitals/hospitals_guidelines.recommend.htm The CDC guidelines do say culture all women during pregnancy, it does not make an exception for RCS. It does state the risk of women with planned RCS is low for GBS and treatment prior to delivery is not necessary. You could extrapolate from that if treatment is not necessary, diagnosis (i.e. routine culture) is not necessary, but that is not what the say explicitly and I will continue to culture all. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Andrew Folley Sent: Thursday, November 29, 2007 12:40 PM To: Multiple recipients of list OB-GYN-L Subject: Re: No Posts! I still have not heard a good argument for doing GBS cultures on women planning repeat c-section. If they show up for the scheduled c-section they did not need the culture. If they come in and decide to be vbac they are either treated as a full term ob with GBS undetermined in which case they are treated based on risk factors, ie >18 hrs ROM or temp >38 C Having said this however, since the ACOG opinion is to get GBS cultures on ALL women other than for those with GBS bacteruria in present pregnancy or hx of GBS disease in prior baby, I guess I will need to start doing cultures on the repeat c-sections at 35-37 weeks. _____ Date: Thu, 29 Nov 2007 14:15:43 -0600 From: dkrell@msn.com To: ob-gyn-l@dns.obgyn.net Subject: Re: No Posts! This patient was screened. GBS +. Penicillin treated in labor w/ at least 2 doses. She did not seek any legal remedy, but had she not been screened, their would have been clear legal exposure. I only brought up this case as an example of how unpredictable this organism is...even when we follow guidelines. Douglas Krell MD _____ Date: Wed, 28 Nov 2007 19:04:41 -0600 From: rd.braun@gmail.com To: ob-gyn-l@dns.obgyn.net Subject: Re: No Posts! How would your screening have helped? That baby needed treatment 48 hours before it was born for it to have done much to help. Dan On Nov 28, 2007 5:13 PM, Douglas Krell < dkrell@msn.com <mailto:dkrell@msn.com> > wrote: Dan, I had a case of twins where twin A was born vaginally unresuscitatable with fulminate GBBS pnuemonia, twin B separate sac breech extraction, was perfectly fine. The mother had been GBBS +. The organism went right through the membranes and killed baby A and a few hours of PCN didn't help. Since then I have screened everyone... I'm just catching a little crap for it. I'll probaBLY CONTINUE to screen if other people do as well. Doug _____ Date: Wed, 28 Nov 2007 15:23:57 -0600 From: rd.braun@gmail.com To: ob-gyn-l@dns.obgyn.net <mailto:ob-gyn-l@dns.obgyn.net> Subject: Re: No Posts! I am aware of one suit brought on this ground. The baby died of GBBS sepsis within 20 hours of delivery. Patient had been in Hospital for less than 2 hours prior to section. Defence was victorius, case never went to court. Dan On Nov 28, 2007 4:08 PM, Meenan, Anna <annam@uic.edu> wrote: We do it, mainly because it would be good to know if the pt. comes in and has a precipitous, unplanned VBAC (in order to decide how to deal with the baby in the nursery). Likewise if she ruptures at home and doesn't realize it (have had this happen to me at least twice in my career) and comes in more than 18 hours later. Otherwise, probably not necessary. Anna Meenan, MD >I guess we have been doing it routinely regardless... >and now that you mention it..it seems unecessary and foolish...yet >another unecessary test. >frances wren > >>----- Original Message ----- >From: Douglas Krell < dkrell@msn.com <mailto:dkrell@msn.com> > >Date: Wednesday, November 28, 2007 1:12 pm >Subject: RE: No Posts! >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net > > >> Here's a quick question for the group. >> Is anyone doing GBS testing on their patients >> planning elective C-section? >> >> Douglas Krell MD >> >> Date: Wed, 28 Nov 2007 13:53:45 -0600From: DoctorJoe@aol.comTo: >> ob-gyn-l@dns.obgyn.netSubject : Re: No Posts! >> >> In a message dated 11/28/2007 1:50:58 P.M. Central Standard >> Time, dean@thehuffpeople.net writes: >> As best I can tell, there have been no posts to OB-GYN-L today. >> Is that true, oris their server broken? >> >> I don't remember seeing any lately. >> >> But this one came thru. >> >> Joe P. >> >> Check out AOL Money & Finance's list of the hottest products and >> top money wasters of 2007. -- R. Daniel Braun, MD FACOG(L) CMT Professor Emeritus Dept. of Obstetrics and Gynecology Indiana U. School of Medicine R. Daniel Braun "Science without Religion is LAME; Religion without Science is BLIND" Einstein 1941 -- R. Daniel Braun, MD FACOG(L) CMT Professor Emeritus Dept. of Obstetrics and Gynecology Indiana U. School of Medicine R. Daniel Braun "Science without Religion is LAME; Religion without Science is BLIND" Einstein 1941 -- _____ Connect and share in new ways with Windows Live. Connect now! <http://www.windowslive.com/connect.html?ocid=TXT_TAGLM_Wave2_newways_112007 > Next message: sharon@methadonesupport.org: "Re: Methadone Pregnancy Info" Previous message: Dr Eberhard W Lisse: "Re: Prophy ABX for Elective C/S was Re: No Posts!" In reply to: Andrew Folley: "Re: No Posts!" Next in thread: Garry E. Siegel, M.D.: "Re: No Posts!"

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