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Re: NEJM TERMPROM From: Douglas Krell (sfth@roadrunner.com) Sat Apr 27 02:37:24 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Douglas Krell: "ankylosing spondylitis and ..." Previous message: Peter V. Weston, M.D.: "Re: need help with weird case." Maybe in reply to: Geff Klein: "NEJM TERMPROM" Next in thread: Luetic5@aol.com: "Re: NEJM TERMPROM" CheriVH@aol.com wrote: . If women > choose to be managed expectantly they are scanned for position and the > presence of at least one 2 cm. pocket of amniotic fluid and sent home with po > antibiotics. They return to L&D once each day for an NST. They are given > printed instructions and take their temperatures at home. We will wait 48-72 > hours after SROM, then begin induction (by prostin or pitocin depending on > cervical ripeness). We have been following this protocol for about 1 1/2 > years now, with very positive results. Our approach is quite different. With PROM, culture for GBstrep and/or GC. If Vtx with reactive NST Wait 12-24hrs If no labor prostin or oxytocin based on bishops score. Only 1 vag exam allowed!!! Treat with antibiotics til rapid Group B strep returns neg. We have lost a few babies with Group B strep sepsis. Either with sudden acute chorioamnionitis or total pulmonary consolidation found on autopsy after acute respiratory failure at birth. If we have a healthy baby at term, we don't have a lot of patients who want to wait around after the membranes have ruptured. What does the Cochrane database have to say on this issue? -- Douglas Krell MD FACOG sfth@roadruner.com Next message: Douglas Krell: "ankylosing spondylitis and ..." Previous message: Peter V. Weston, M.D.: "Re: need help with weird case." Maybe in reply to: Geff Klein: "NEJM TERMPROM" Next in thread: Luetic5@aol.com: "Re: NEJM TERMPROM"

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