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Re: A case From: Robert J. Woolley (wooll005@gold.tc.umn.edu) Thu Dec 5 21:51:28 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr Pravin Kini: "Re: mifepristone" Previous message: Richard Kaplan: "Re: leiomyomata" Maybe in reply to: Sing-Hung Chang: "A case" Next in thread: douglas krell: "Re: A case" In message <199612060225.SAA12055@unixg.ubc.ca> writes: > > > With respect to your last sentence. If the induction fails they are > delivered by other means. I do not practice serial inductions, I only > induce patients that need to be delivered. If they do not deliver > vaginally then they will deliver abdominally. > So at 41 weeks, you routinely try induciton, and if it fails you then will routinely section, even if there are no indications of fetal compromise? You certainly can't derive justification for this practice from the Hannah study. Is there any evidentiary support for it? I'll also note that you must surely wipe out one of the major claims that you made for induction over monitoring: the reduced c-section rate. Remember that in the Hannah study the rate was 24.5% in the monitored group, and 21.2% in the induction group, an obviously small--though statistically significant--difference. If I am understanding your practice correctly, it seems inevitable that you will end up with a *higher* section rate than you would if you didn't routinely induce. This means that the only possible justification for your policy of routine induction is the potential for lower perinatal mortality, which, as you know, was not shown by the study you are relying on as the basis of your protocol! I do hope I have misunderstood your explanation. --------------------------------------------------------------------------- --------------------------------------------------------------------------- Bob Woolley -- --------------------------------------------------------------------------- St. Paul, Minnesota "Two vast things, each wondrous in itself, contribute to make this book a prodigy--the author's industry and her ignorance. Once can only be so intricately wrong by deep study and long effort.... The result has an eerie perfection, as if all the world's greatest builders had agreed to rear, with infinite skill, the world's ugliest building." --Garry Wills, on Fawn Brodie's psychobiography of Thomas Jefferson Next message: Dr Pravin Kini: "Re: mifepristone" Previous message: Richard Kaplan: "Re: leiomyomata" Maybe in reply to: Sing-Hung Chang: "A case" Next in thread: douglas krell: "Re: A case"

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