Re: What's next
From: Efrain Ramirez (eramirezt@coqui.net)
Thu Apr 24 20:57:52 2008
Agree!!!!
Ef
At Thu, 24 Apr 2008, R. Daniel Braun wrote:
>
>Steroids do more than prevent RDS. They also decrease incidence of IVH and
>NEC, which can still occur after 34 weeks. Risk of giving steroids is ??????
>
>Dan
>
>On Thu, Apr 24, 2008 at 9:05 AM, Andrew Folley <agfolley@hotmail.com> wrote:
>
>> I must have missed how the diagnosis of IUGR was made?agf
>>
>> > Date: Thu, 24 Apr 2008 06:11:49 -0500
>> > From: cdsb@bellsouth.net
>> > To: ob-gyn-l@mail.obgyn.net
>> > Subject: RE: What's next
>> >
>> > 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
>> >
>>
>> ------------------------------
>> Make i'm yours. Create a custom banner to support your cause.<http://im.live.com/Messenger/IM/Contribute/Default.aspx?source=TXT_TAGHM_MSN_Make_IM_Yours>
>> ------------------------------
>> ------------------------------
>> ------------------------------
>>
>> ------------------------------
>
>> ------------------------------
>--
>> ------------------------------
>R. Daniel Braun, MD FACOG(L) ABMP CMTh
>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
>
--
"I can accept failure, but I can't accept not trying." - Michael Jordan
|
|
