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Re: 7 to 25% CS (was: Denmark the Csection rate...)From: Ealgail@aol.comMon Aug 11 00:08:08 1997
In a message dated 97-08-10 11:47:14 EDT, you write: << believe a c/s in a patient at 8 cm for over 2 hours and with an estimated fetal with of aprox. 8 lbs. increase the infant's chance for a intact survival? >> Not necessarily, I think it might show the deceleration phase of the Friedman curve, where you might have an OP or transverse arrest. The estimated weight is probably not helpful in the decision. << repetitive late decelerations in a primigravida in active labor(4cm) will increase the infant's chance? >> Maybe, if they are really repetitive lates and not variables. The true incidence of fetal distress is estimated by several studies to be about 2%. <<there is also a too low c/s rate (probably less than 5%).>> Yes, we can't get there in the U.S. due to our population. A couple of years ago, the University of Florida Medical School Ob/Gyn residents got their c/section rate down to 10-11% before a faculty member ordered them to get it back up again. I think we are working to get the over 20 percent rates down. Over 30%, IMHO, is outrageous and any hospital administrator who has such a rate should ask for an independent evaluation of quality and practice patterns by a team from ACOG. Linda Linda Morrison-Boczar, MD, MBA, FACOG Private Practice - Sarasota, FL
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