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Re: Prior cesarean, SGA, need your help....From: Jose C. Ferreira (zec@inx.net)Thu Jul 31 06:24:33 1997
How is the amniotic fluid? Have you done Umbilical artery Doppler? And even the placenta? If everything was normal, I would consider it either just a small fetus or a fetus small for a fetal condition (it is to late to rule out), and not a IUGR (if nothing new happens); thus, I would follow it with fetal mouvement count, NST 2/week, Amniotic fluid surveillance once/week and fetal biometry every other week. If everything was normal I would deliver the way you use to do, independently of the size of the baby. If something appeared really abnormal I would deliver independently of maturity status. Jose Ferreira zec@inx.net Ob.-Gyn. Department, Garcia de Orta Hospital, Portugal Genetics Fellow, Montefiore Medical Center (AECOM), New York
-- ---------- > From: Geffrey H. Klein, MD <gklein@bcm.tmc.edu> > To: Multiple recipients of list <ob-gyn-l@talk.obgyn.net> > Subject: Prior cesarean, SGA, need your help.... > Date: Wed, 30 de July de 1997 8:49 PM > > Hi all.. > > New case > > 27 y/o G4P1A2 started prenatal care with this office at 31 wks gestation. > Prior doctor did ultrasound at 15 wks supporting due date of 8/16/97. > Patient has prior cesarean section with an LUT incision. Patient refusing > TOL. Ultrasound was ordered 7/14/97 due to size less than dates. EFW at > 35 3/7wks by U/S was 1900g (~10%). Repeat U/S by me on 7/15/97 (I did not > have the report until later that day) was 2200g (greater than 10%) but head > was 35 wks and body was 33 wks. AFI was 20. At that point I decided to get > weekly NST's which have been reassuring. > > I had her at the hospital today at 37 4/7 wks. > > Strip was reactive. No contractions. > > My plan was to tap and deliver if mature... > L/S was 1.2 and PG was 0.0. > > Questions: > 1) Should I have just sectioned her? > 2) Now that I documented immature lungs, what should I do?
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