Re: procardia for chronic tocolyis
From: Douglas Krell (dkrell@msn.com)
Wed Oct 29 20:46:35 2008
I would treat her with whatever is working...
Procardia, Terbutaline, Magnesium Sulfate if necessary.
I usually give 24 hours at a minimum for the steroids to work.
If she has stabilized on Procardia, I would continue it until at least
35 weeks if you can.
--
Douglas Krell MD
> Date: Wed, 29 Oct 2008 21:25:47 -0500
> From: garrys@mindspring.com
> To: ob-gyn-l@mail.obgyn.net
> Subject: Re: procardia for chronic tocolyis
>
> In general, if I use Procardia for tocolysis, I'll keep them on it until
> 35 weeks.
>
> Speaking for myself, I try not to use tocolysis unless there is cervical
> change associated with contractions.
>
> That said, I recently had a set of 30w4d twins who was feeling pressure..
> Her cervix was 0/50/-1 (very low) and an FFN was positive. She was
> irritable.
>
> Would you treat with Procardia or something else while giving steroids?
>
> If she is stable after steroids, would you keep her on it?
>
> Garry
>
> At Wed, 29 Oct 2008, Andrew Folley wrote:
> >
> >Questioning the benefits of leaving on procardia until 34 weeks? ie In the interest of evidenced based medicine are are we treating the patient or the physician?> Date: Wed, 29 Oct 2008 10:03:42 -0500> From: el@lisse.NA> To: ob-gyn-l@mail.obgyn.net> Subject: Re: procardia for chronic tocolyis> > I keep them on Nifedipine 10mg 8hourly for a while under the assumption> that it increases bloodflow to the uterus and has virtually no side> effects.> > What's the issue?> > el> > > on 10/29/08 4:46 PM Andrew Folley said the following:> > Does anyone use procardia on a chronic basis for patients syptomatic> > with prematrue labor?> > Typically we will have someone admitted with PML and short cervix (ie> > <15mm) and they receive procardia and steroids. Usually are then left> > on procardia 10-20mg q 6 hrs indefinitely. Is this a routine anywhere> > else and is there any danger in this? I am familiar with cochrane study> > showing no befefit to chronic tocolysis. andy>
>
> --
> Garry E. Siegel, M.D.
> Private Practice
> Roswell, GA
