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Re: (no subject) From: richardc@bcm.tmc.edu Sat Jan 4 11:11:07 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr Eberhard W Lisse: "Re: Uterine rupture, pregnant again" Previous message: BRIDERON Jean-Michel: "Re: AIUM Certification" In reply to: Geffrey H. Klein, MD: "Re: (no subject)" Next in thread: Paul Prior MD: "Re: (no subject)" At Sat, 4 Jan 1997, Geffrey H. Klein, MD wrote: > > >As this is an unusual situation, I am unaware of any literature to answer >this question. I am a little confused, if you had a uterine rupture with >the second pregnancy, how did you have a classical incision? > >My recommendations would not be founded in any scientific data. However, >if you truly desire to continue this pregnancy, I would recommend early >elective repeat cesarean at 37-38 weeks gestation. Surveillance for >symptoms of uterine rupture prior to this should be reported to the doctor. >You should be prepared for possible hysterectomy as there are at least two >conditions that are higher risk with your history. These include placenta >previa (placenta cover the cervical opening and is prone to bleed) and >placenta accreta (placenta invades the muscle of the uterus). > I agree with the management, althought empirically I might give a course of betamethasone at 30 weeks or so, and amnio at 34 weeks for FLM. I would also get steriliation permits and counsel regarding the probability of C-hyst. Rick -- Rick Chudacoff, MD Baylor College of Medicine BaylorMedCare Houston, TX Next message: Dr Eberhard W Lisse: "Re: Uterine rupture, pregnant again" Previous message: BRIDERON Jean-Michel: "Re: AIUM Certification" In reply to: Geffrey H. Klein, MD: "Re: (no subject)" Next in thread: Paul Prior MD: "Re: (no subject)"

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