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Re: Seeking your opinion From: Brian Hackman (brianhackman@easynet.co.uk) Mon Jul 14 22:45:21 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Deborah Wage: "Re: VBAC of >1 previous C/S- Malcolm's response" Previous message: Gary Kleinman: "Re: Genetics Help" In reply to: Robert J. Carpenter, Jr. MD: "Re: Seeking your opinion" Next in thread: HPGeorge@aol.com: "Re: Seeking your opinion" >Date: Sat, 12 Jul 1997 17:47:18 -0500 >Reply-to: ob-gyn-l@obgyn.net >From: rradnich@dca.net (Robert Radnich, M.D.) >To: Multiple recipients of list <ob-gyn-l@talk.obgyn.net> >Subject: Seeking your opinion I do not believe one should carry out a caesarian section for a dead baby unless there is no alternative. I would wait for as long as possible, ideally until the onset of spontaneous labour, to give maceration a good chance to soften the baby and reduce the amount of csf. At full dilatation I would perforate the skull with a chest drain and then the head is usually quite easy to extract. One word of warning, if you have not done it before, the chest drain is inclined to skid across the skull and penetrate the pelvic side wall. Steady pressure into a suture is needed to prevent this happening. Brain Hackman > >Colleagues, > >I would appreciate your opinions regarding the management of the >following case: >17 yr. P0 at 35-36 wks with known fetal hydocephalus. Amnio 46xy. Had >discussed delivery by C/S at tertiary center because fo significant >hydocephalus. Presents for fetal surveillance studies and found to have >intrauterine fetal demise. Vertex is presenting. I'm not sure what the >status of the cervix was. > >Would you suggest cesarean section as had been previously discussed? >Would you suggest induction of labor with or without some sort of >drainage proceedure of the fetal head? > >Thanks for your input. > >Bob > >-- >R.H. Radnich,MD,FACOG >OB/GYN Associates of Dover >540 S. Governors Ave. >Dover, Delaware 19904 > >Dear Dr radnich, > >Given the issue of IUFD, vaginal delivery would be the perferred way >of delivery. Percutaneous deccpompression of some of the CSF is >reasonable. If the cervix is effaced/dilated then that could be >accomplished vaginally. If the head is not in the pelvis, then the >abd method would be best with induction of labor to follow. Post >delivery please give the list your chosen method and outcome. > >Thanks, >R.J Carpenter, Jr. >6624 Fannin, #2720 >Houston,Tx 77030-2339 >713-795-4600 -- Brian Hackman, Butts House, Church Road, Glatton, Cambridgeshire, PE17 5RR. U.K. Tel.(+)1487830645 Fax.(+)1487832949 Next message: Deborah Wage: "Re: VBAC of >1 previous C/S- Malcolm's response" Previous message: Gary Kleinman: "Re: Genetics Help" In reply to: Robert J. Carpenter, Jr. MD: "Re: Seeking your opinion" Next in thread: HPGeorge@aol.com: "Re: Seeking your opinion"

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