Re: active tracing with decell
From: art fougner, md (evsono@pipeline.com)
Fri Dec 21 11:28:34 2007
GYN doesn't get you off the hook for Failure to Diagnose Breast Cancer.
Cheers!
Art
At Fri, 21 Dec 2007, Richard Chudacoff wrote:
>
>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
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
