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Re: 20 weeks with PPROM + previaFrom: dahmd@gate.netMon Jul 1 17:59:49 1996
In article "R. Daniel Braun" <rBraun@IUNET.IUPUI.EDU> writes:
>I doubt that she has a complete previa or that she has ruptured I see your point, but disagree. There are a number of possibilities. There could be a "high leak" above the previa, or more likely there could be a leak at the os with leakage around the placenta. Water, or amniotic fluid, has amazing abilities to sneak around barriers. For brevity, I did not mention that she had an amniocentesis with instillation of indigo carmine that leaked into the vagina (amnio negative for infection). She is not my patient, but I'm sure the physician managing her can diagnose leaking indigo carmine!
>If she opted for induction, I would utilize prostaglandin. IF SHE STARTED I think this is pretty reasonable. A type and cross for a few units would be prudent beforehand. This may be the way they proceed with her care.
>Ultrasound at 20 weeks is not very good at diagnosing previa. Rupture of Agreed, but high-resolution sonography performed with multiple, experienced physicians in attendance, and color-flow doppler have both documented placenta wrapped around the os. They even performed a bried vaginal probe which showed the same thing. You'll have to trust me on this one: she has a previa. Thanks for the assistance, Ashley D. Ashley Hill, M.D. Assistant Director Dept of Ob/Gyn Florida Hospital Family Practice Residency Orlando, FL
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