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Re: 20 weeks with PPROM + previa From: R. Daniel Braun (rBraun@IUNET.IUPUI.EDU) Mon Jul 1 16:05:32 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: dahmd@gate.net: "Re: 20 weeks with PPROM + previa" Previous message: Ronald Helm: "Re: 20 weeks with PPROM + previa" Maybe in reply to: dahmd@gate.net: "20 weeks with PPROM + previa" Next in thread: dahmd@gate.net: "Re: 20 weeks with PPROM + previa" I doubt that she has a complete previa or that she has ruptured membranes. They don't go together. If she has a total previa, how does the fluid get out without severe hemorrhage ??? If she opted for induction, I would utilize prostaglandin. IF SHE STARTED TO BLEED HEAVILY PRIOR TO ANY DILATATION ONE WOULD BE FORCED TO DELIVER ABDOMINALLY. (sorry, I hit the caps lock) If she dilated and then bled, one could use any of a number of maneuvers to apply pressure to the placenta and stop the hemorrhage. Ultrasound at 20 weeks is not very good at diagnosing previa. Rupture of BOW and loss of fluid makes it even worse. The lower uterine segment (read upper cervix) has an ultrasound appearance that is very similar to placenta. -- @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ R.Daniel Braun, MD FACOG "Money will buy you a fine dog Clinical Professor but only love will make it wag Dept. OB/GYN it's tail.", Indiana U. School of Medicine Richard "Kinky"Friedman Racetown @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@> <dahmd@gate.net> 07/01/96 02:03pm >>> A clinical dilemma for your consideration: A 16 year-old primigravida at 20 weeks (menstrual history and 8 week ultrasound) arrives with documented preterm premature rupture of membranes (PPROM), not in labor, and a non-bleeding complete placenta previa on ultrasound. She was given information about induction of labor versus "expectant management" and was leaning towards induction, until the ultrasound revealed the previa. If she wanted termination for PPROM at 20 weeks, would anybody do a c/s (essentially a hysterotomy) to deliver the baby? Thanks in advance. Ashley Hill Orlando, FL dahmd@gate.net Next message: dahmd@gate.net: "Re: 20 weeks with PPROM + previa" Previous message: Ronald Helm: "Re: 20 weeks with PPROM + previa" Maybe in reply to: dahmd@gate.net: "20 weeks with PPROM + previa" Next in thread: dahmd@gate.net: "Re: 20 weeks with PPROM + previa"

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