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Re: A caseFrom: DoctorJoe@aol.comMon Dec 2 08:20:40 1996
<<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?>> Induce, amnioinfusion, monitor closely. Deliver because you have severe oligohydramnios, enough to give spontaneous deccelerations, in a term (or after term) infant, in the face of a ripe cervix. The real question is, do you WAIT? And WHY or WHY NOT? I would think WAITING is what you would have to justify, not delivery. Joe P.
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