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Re: IUPC placement was: glove use in L&DFrom: Garry E. Siegel (garrys@atl.mindspring.com)Fri Jan 10 16:11:20 1997
At 12:22 PM 1/10/97 -0600, you wrote> >Speaking of which, how often do you examine the cervix? I rarely examine >before 40 weeks, unless there is a reason. Once in labor I remember >what Dr. Day said. "Exam at the time of admission, the time of >analgesia and the time of delivery." I try to follow that, unless there >is a cause to do more. What do y'all do? > >Rick Interesting. I examine more traditionally, meaning at 38 weeks and weekly in the office. I do not hesitate to examine a cervix in the office at any time, excepting a known previa. I do like to assure myself that people are vertex, and the vag exam usually confirms Leopold's, by feeling the presenting part in the fornices in an undilated primiparous cervix. Once that is ascertained, I cannot justify further exams, although many woman want to know so they can pontificate about it. In multips with great cervices, ie 3 or 4, 70%, it may let them be better prepared to hurry in once in labor. In residency, all cervices were checked hourly; in practice this is too often, but I think that progress needs to be monitored, especially in primips (and if you believe in active management protocols). My 0.02 Garry
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