|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: are you a litiganist?From: Terrence.Jones@ncal.kaiperm.orgTue Jul 9 15:32:41 1996
Vivienne, there are two decent reviews on AI (amnioinfusion), both of which list complications and assoc ref's. In each case the complications are not consistent findings, nor do they occur any more freq. than in labors not assoc with AI. "Amnioinfusion. A Review." Lamier & Katz (Chapel Hill) Obs & Gyn Survey (12/93) vol 48: 829-37. "Amnioinfusion. A Review." Pazkowski (Poland) J Rep. Med. (8/94) vol 39: 588-94. (I'm never quite sure if I should apologize, when citing the J. Rep Med? :) The review by Wenstrom & Maher (O/G 10/95, 86:572-6), studied technical differences and complication rates from data pooled from 78 MFM programs, and an additional 206 residency programs, and found no differences. The case report from Adair (South Med J 8/95, 88:847-8) described uterine rupture in a pt with prior c/s undergoing TOL. However, a prior study by Strong (O/G 5/92, 79:673-4), showed no uterine rupture in the 18 of 901 (2%) of VBAC Pts. receiving AI. Another study by Wenstrom & Maher (O/G 5/94, 83:851-4) described 2 cases of AFE (amniotic fluid embolism) in pts with AI. It is unclear whether any causal relationship exists, particularly in light of recent speculation into the immunologic-cytokine-mediated mechanisms of AFE. However, placing a device that has the potential to expose uterine endothelial surfaces to the contents of the amniotic cavity, or disrupt the integrity of the myometrium, should reinforce the importance of proper technique. Regarding Gary's interesting case, and Mat's response Re: Candida, and tying it in with the issue of AI -- there was an interesting case report from AJOG (5/94) by Shalev describing the use of AI to administer Ampho- terrible B to a Pt with PTPROM at 27 wks with Candida. For me, this is going WAY out there, but for this case, I guess it was the YEAST they could do. The Pt. had no s/s of systemic infxn, the Dx was by culture after neg. gram stain, the baby did well with mild RDS (1030 gms). (AJOG 170:1271-2). Terry Jones Kaiser SF Ob/Gyn
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 05:18:59 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.