A case
From: Sing-Hung Chang (changl@cariari.ucr.ac.cr)
Sun Dec 1 13:09:37 1996
17 y/o, primigravida, 41 3/7 wks, adequate prenatal care, came to the
hospital claiming 3 days of absent fetal movements. She had only slight
irregular uterine contractions, no history of watery discharge. Her
examination revealed: FH 35 cm, elevated uterine tone, FHR 152 bpm on
Doppler, with desaccelerations (down to 60 bpm). Upon admission, a NST was
reactive, adequate variability, showing some cord compression pattern, but
without any real desacceleration on a 30-minute recording. The US revealed
severe oligohydramnios (AFI = 2.0), BPP=4/6. EFW = 3600 g.
Her cervical conditions were 3 cm dilated, 70% effaced. Vertex, station -
2, intact membranes. The pelvis was clinically assessed as adequate for
vaginal delivery.
Question: Is amnioinfusion + labor induction absolutely indicated in this
setting? Why or why not?
Thanks for your opinions.
--
Sing-Hung Chang, MD
Resident
|
|
