Re: active tracing with decell
From: Richard Chudacoff (rchudacoff@mylinuxisp.com)
Fri Dec 21 09:16:42 2007
Another reason to only do GYN
--
Richard Chudacoff, MD, FACOG
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of art
fougner, md
Sent: Friday, December 21, 2007 6:27 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: active tracing with decell
Cautionary tale: Obtaining a consult does not absolve the referring
physician of responsibility. It merely adds yet another name to the
summons. Of course, I practice in NY, so your local situation may be
better.
Art
At Thu, 20 Dec 2007, Joanne Bulley, MD wrote:
>
>Only if the fetus survives the trip to the MFM while out of your care
>but not yet in the MFM's care!
>
>Joanne
>
>(being devilish)
>
>At Thu, 20 Dec 2007, Richard Chudacoff wrote:
>>
>>Ah, but the latter absolves me of all responsibility :-)
>>
>>--
>>Richard Chudacoff, MD, FACOG
>>
>> _____
>>
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of R.
Daniel
>>Braun
>>Sent: Thursday, December 20, 2007 6:11 AM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: active tracing with decell
>>
>>I'm not so sure that the 3rd one is such a good one though.
>>
>>So Andrew,
>>What have you done???? Do you know the outcome, yet?
>>
>>Dan
>>
>>On Dec 20, 2007 8:18 AM, Richard Chudacoff, MD <
rchudacoff@mylinuxisp.com>
>>wrote:
>>
>>For me the solution is simple. I have a healthy baby now. I do not know,
if
>>she leaves L&D, that I will still have a healthy baby n 24-48 hr. So I
>>believe only three options exist: deliver, continuous monitoring on L&D
>>until delivery, transfer to MFM.
>>
>>Richard Chudacoff, MD, FACOG
>>-sent from my Treo 650
>>
>>-----Original Message-----
>>
>>From: "Raymond Stephen" < Stephen.Raymond@dhhs.tas.gov.au
>><mailto:Stephen.Raymond@dhhs.tas.gov.au> >
>>Subj: RE: active tracing with decell
>>Date: Wed Dec 19, 2007 10:04 pm
>>Size: 2K
>>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net
>><mailto:ob-gyn-l@dns.obgyn.net> >
>>
>>Compare the number of times you have seen a true knot at delivery of a
>>well child and the number of cases of intrauterine death due to a true
>>knot. Further, because of the turgidity of the cord due to its blood
>>pressure there is room for doubt that cord accidents are the cause of
>>death rather than the antecedent of death from other blood flow
>>problems.
>>
>>Steve
>>
>>________________________________
>>
>>________________________________
>>________________________________
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>>
>>--
>>________________________________
>>westsidebirthservice@juno.com <mailto:westsidebirthservice@juno.com>
>>________________________________
>>________________________________
>>Sent: Thursday, 20 December 2007 1:50 AM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: active tracing with decell
>>
>>Could be true knot that isn't fatal. Your'e going to deliver "just in
>>case?"
>>
>>Just wondering where the dividing line is between the "every birth is a
>>disaster waiting to happen and can't be diagnosed as normal until after
>>the event" and "birth is a natural event with some fatal outcomes due to
>>(someties cord) accidents." And what of the sequela of delivering a
>>preterm baby because of the fear of a fatal cord accident?
>>
>>Louana
>>
>>-- Joe <forcep@intercom.net <mailto:forcep@intercom.net> > wrote:
>>Excellent point, Dan. Could have true knot which could be fatal. Joe C
>>
>>R. Daniel Braun wrote:
>>> That makes no sense at all. If you have cord entanglement
>>
>>theoretically
>>> it could at any time become so severe that it kills the baby. So
>>> logically you have to either monitor her continuously until delivery
>>or
>>> ignore it. NST's and CST's don't predict anything about cord problems,
>>
>>> only about UPI. Therefore they are of no benefit.
>>>
>>> IMHO
>>> Dan
>>>
>>> On Dec 18, 2007 8:05 PM, Raymond Stephen
>>> <Stephen.Raymond@dhhs.tas.gov.au
>>> <mailto: <mailto:Stephen.Raymond@dhhs.tas.gov.au>
>>
>>Stephen.Raymond@dhhs.tas.gov.au>> wrote:
>>>
>>> And, you're going to mess up her sugars. Ask yourself shy she had
>>the
>>> deceleration - can't be placental insufficiency, no IUGR, so it
>>has to
>>> be an intermittent cord compression,? entanglement, probably won't
>>> happen again, why not just check CTG regularly?
>>>
>>> -----Original Message-----
>>> From: ob-gyn-l@obgyn.net <mailto:ob-gyn-l@obgyn.net>
>>> [mailto:ob-gyn-l@obgyn.net <mailto: ob-gyn-l@obgyn.net
>><mailto:ob-gyn-l@obgyn.net> >] On Behalf
>>Of
>>> Richard Chudacoff
>>> Sent: Wednesday, 19 December 2007 11:51 AM
>>> To: Multiple recipients of list OB-GYN-L
>>> Subject: RE: active tracing with decell
>>>
>>> That is true, especially in this case with GDM. But hey, that is
>>why I
>>> don't
>>> deliver anymore
>>>
>>> Richard Chudacoff, MD, FACOG
>>>
>>--- message truncated ---
>>
>>--
>>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
>>
>--
>Joanne Bulley, MD, FACOG
>Solo gyn
>Keene, NH USA
>
>more snow on the way!
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
