Re: What's next
From: Joe Cutchin (forcep@intercom.net)
Thu Apr 24 08:42:02 2008
There may be ten different ways but if this baby does die in utero there
will be only ONE way in court. Joe C
Charles Bloom wrote:
> I don't give steroids after 34 weeks either. And Garry is right, the baby
> isn't thriving, it's small.
>
> But if the fetus were say 30 weeks with IUGR, but with Reactive NST and 8/8
> BPP, then I think there wouldn't be such a rush to delivery.
>
> So the real question here I think is given an IUGR fetus with perfect
> testing, what is the EGA we would electively deliver?
>
> Everyone may have a different answer. Here is an example of there being 10
> different ways to do something in medicine and nine of them not being wrong.
>
> Charles
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E.
> Siegel, M.D.
> Sent: Wednesday, April 23, 2008 10:47 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: Re: What's next
>
> Over 34 weeks--no steroids unless amnio done and lung maturity not
> proven.
>
> Yes, the late preterm baby alluded to in ACOG's Committe Bulletin has
> more morbidity, etc., but this baby is far from thriving inside.
>
> Reassuring testing is nice, but nicer is a baby in the nursery.
>
> Deliver her, my friend.
>
> Garry
>
> At Wed, 23 Apr 2008, Efrain Ramirez wrote:
>
>>No fetal weight gain at all in the last 2 weeks.. umbilical artery
>>doppler normal.. MCA not done.. mother perceives fewer FM's.. just
>>like the other pregnancy.
>>Definitive asymmetric IUGR.
>>Level III NICU .. I had to deliver in the last year to babies at 26
>>weeks .. doing well..
>>Steroids? - it's a Democratic Primary..
>>Legally speaking an unexpected IUFD would be hard to defend... NICU
>>complications, IMHO, easier.
>>Thanks to all.. recommendations well taken.
>>
>>Ef
>>
>>At Wed, 23 Apr 2008, art fougner, md wrote:
>>
>>>Middle cerebral artery doppler? Uterine artery doppler?
>>>If all normal, would suggest (unencumbered by data) twice weekly nst's
>>>with AFI's, weekly dopplers and elective delivery at term.
>>>
>>>Art
>>>
>>>Just my opinion. I could be wrong.
>>>
>>>At Wed, 23 Apr 2008, Efrain Ramirez wrote:
>>>
>>>>30 some G2, P1 - previous C/S - IUGR - at 36 weeks - apparently no
>>>>reassuring FHR's.2 weeks at NICU.. at present 34 w and 5 d.. BPP
>>>>10/10, EFW - 1500-1600 below 5th.. normal umbilical Doppler .. what's
>>>>next?
>>>>
>>>>Ef
>>>>
>>>>--
>>>>"I can accept failure, but I can't accept not trying." - Michael Jordan
>>>>
>>>
>>>--
>>>art fougner, md
>>>"May The Wings of Liberty Never Lose a Feather." - Jack Burton
>>>
>>
>>--
>>"I can accept failure, but I can't accept not trying." - Michael Jordan
>>
>
> --
> Garry E. Siegel, M.D.
> Private Practice
> Roswell, GA
>
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