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Re: A caseFrom: T-H Bui, Clinical Genetics, Karolinska Hospital (bui@gen.ks.se)Mon Dec 2 06:06:35 1996
At 14.09 1996-12-01 -0600, Sing-Hung Chang wrote: >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? There are two approaches: you have to monitor this pregnancy on a dayly basis (NST, Doppler, AFI) until spontaneous labour or you induce labour. In both situations you may need amnioinfusion. I would choose to induce labour because the benefit of waiting for spontaneous labour is limited and not without some danger. The-Hung Bui, MD Associate Head Director Fetal Diagnosis Program Dept. of Clinical Genetics, Karolinska Hospital, S-171 76 Stockholm, Sweden Consultant Obstetrician-Gynecologist (Fetal Medicine) Dept. of OB&GYN, Huddinge University Hospital, Karolinska Institute, S-141 86 Huddinge, Sweden phone: +46 8 729 4989 (office) or 729 2472 (secretary) fax: +46 8 32 77 34; e-mail: bui@gen.ks.se
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