Re: Total Previa
From: R. Daniel Braun (rd.braun@gmail.com)
Mon Dec 29 06:34:05 2008
I agree with Steve and Ef.
I think that we decided on this list about 5-8 yrs ago that there was seldom
if ever an indication to do an amnio for "Maturity". Either she needs
delivery or she doesn't. In this case, if she bleeds again(and she probably
will), she needs delivery.
Dan
On Sun, Dec 28, 2008 at 11:01 PM, Raymond Stephen <
Stephen.Raymond@dhhs.tas.gov.au> wrote:
> For what it is worth, I am in agreement with you Efrain. If there is no
> further bleeding then there is no indication to deliver. This means that
> you either wait until the fetus is mature - i.e. close to 39 (38 would work
> for me), or you section her at the next episode of bleeding unless it is
> very minor. There is some evidence these days that a repeat course of
> steroids is of value if it is more than two weeks since the last one.
>
> Steve
>
> ------------------------------
> *From:* ob-gyn-l@obgyn.net on behalf of Efrain Ramirez
> ------------------------------
> *Sent:* Mon 29/12/2008 2:26 PM
> ------------------------------
> *To:* Multiple recipients of list OB-GYN-L
> *Subject:* Re: Total Previa
>
> No..no bleeding -- partner wants to give another shot of steroids, do
> amnio at 35, if mature C/S - I favor no amnio and do elective C/S at
> 36-37, if there is another episode of bleeding then do C/S - I would not
> argue against another shot of steroids.
>
> Ef
>
> At Sun, 28 Dec 2008, DoctorJoe@aol.com wrote:
> >
> >In a message dated 12/28/08 7:49:53 PM, eramirezt@coqui.net writes:
> >
> >> 20 some years old GI, total placenta previa with 4 episodes of bleeding
> >> - hospitalized at 28 weeks, corticosteroids given at that time,
> >> currently 34 2/7 weeks..next steps, when, why?
> >>
> >Currently bleeding?
> >
> >I think we had this discussion recently, at least to some extent.
> >
> >Get her as far as you can and do an elective C-section with informed
> consent
> >for a hyst, if necessary. (So it's very important to get a good baby this
> >time.)
> >
> >Joe P.
> >
> >icid=aolcom40vanity&ncid=emlcntaolcom00000025)
>
> --
> "I can accept failure, but I can't accept not trying." - Michael Jordan
>
> CONFIDENTIALITY NOTICE AND DISCLAIMER
>
> The information in this transmission may be confidential and/or protected
> by legal professional privilege, and is intended only for the person or
> persons to whom it is addressed. If you are not such a person, you are
> warned that any disclosure, copying or dissemination of the information is
> unauthorised. If you have received the transmission in error, please
> immediately contact this office by telephone, fax or email, to inform us of
> the error and to enable arrangements to be made for the destruction of the
> transmission, or its return at our cost. No liability is accepted for any
> unauthorised use of the information contained in this transmission. If the
> transmission contains advice, the advice is based on instructions in
> relation to, and is provided to the addressee in connection with, the matter
> mentioned above. Responsibility is not accepted for reliance upon it by any
> other person or for any other purpose.
>
--
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
