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Re: PPROM at 34 wksFrom: Geffrey Klein (GK6972@americanmed.com)Sat Aug 30 10:27:31 1997
> >Dear Geff: >I too would not induce except for maternal/fetal indications. As long >as mom is afebrile and baby happy on the strip, just wait. She will >probably declare herself soon anyway, but you just might get that other >dose of steroids in. >BTW, why ampicillin AND erythro? I use Unasyn as it appears to prolong >latent period. >Just wondering. > I don't have the exact reference for the amp + erythro.. I can look it up at home. I have a book that I carry around with all of the stuff that I have collected over the years. The amp/erythro protocol was presented at a grand rounds, conference, or journal club that I attended.. I don't anticipate that i will be at home anytime soon. I am in L&D and these ladies are taking "labor" day weekend a bit literal.. There are three in labor right now... So if someone has a reference.. I agree that a generic 34 weeker with SROM, no signs of infection, and reassuring fetal monitoring might be a candidate for expectant management. However, my concern is the unexplained elevated MSAFP coupled with the documented wt of less than 10th percentile for GA and maternal perception of decreased fetal movement... I don't anticipate I will get a week, so why add chorio/fetal distress on top of that?
Geff Klein, MD
geffrey.klein@obgyn.net
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