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Re: ruptured membranes and Shirodkar From: John G. M. Robertson (jgmr@unixg.ubc.ca) Sat Nov 29 22:41:50 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: John G. M. Robertson: "Re: ruptured membranes and Shirodkar" Previous message: shiraz suleman: "ruptured membranes and Shirodkar" Maybe in reply to: shiraz suleman: "ruptured membranes and Shirodkar" Next in thread: John G. M. Robertson: "Re: ruptured membranes and Shirodkar" Patient #1 Is she in labour - if so take it out (and if you feel so inclined pray). If she is not you are "damned if you do and damned if you don't". I would monitor for signs of infection (both maternal and foetal), and remove at the first sign of same. Patient #2 Why are there bulging membranes - is this truely an incompitent cervix or is this premature labour. If this is an incompitent cervix a cerclage MAY be appropriate. ***Warning - Incomming anecdote*** When I was in residency we had a lady with twins who was having colposcopy for an abnormal pap smear and was found to have bulging membranes (actually I diagnosed the twins after she was sent in from the colposcopist - but that is another story). We put her on bed rest for a week in trendellenburg, and gave her indocid (to decrease the amniotic fluid) then put in a suture and she carried to 38 weeks (suture placed at 22 weeks). Not sure if any of the treatment was previously confirmed by RTCs but it appeared to work for her. John J.G.M.Robertson MD, 109-9181 Main St. Chilliwack, B.C. V2P 4M9 (604) 793-9988 e-mail jgmr@unixg.ubc.ca The best we can do for one another is to exchange our thoughts freely; and that, after all, is about all. James A. Froude (1818-1894) -----Original Message----- From: shiraz suleman <suleman@sk.sympatico.ca> To: Multiple recipients of list <ob-gyn-l@talk.obgyn.net> Date: Saturday, November 29, 1997 8:44 PM Subject: ruptured membranes and Shirodkar >I have just seen a patient in ER who is 22 weeks pregnant.She has been >bleeding for the past 2 hours[spontaneous and no pain].She had 3 >previous miscarriages[fully investigated] .A shirodkar was insereted >at 13 weeks.On examination she was well.Apyrexial.Draining blood stained >lichor vaginally.U/S-normal baby and lichor. >The question is would you remove the stitch.If not is she not at risk of >getting infection with the stich insitu? > >A second patient at 18 weeks who had been spotting from early on in >pregnancy.She presents with bulging membranes.The cervix is 3 cm dilated >and almost fully effaced.Who does emergancy cerclages and how good are >your results?Busy night! > >-- >Dr Shiraz Suleman >Consultant OB >Prince ALbert >Canada >suleman@sk.sympatico.ca > Next message: John G. M. Robertson: "Re: ruptured membranes and Shirodkar" Previous message: shiraz suleman: "ruptured membranes and Shirodkar" Maybe in reply to: shiraz suleman: "ruptured membranes and Shirodkar" Next in thread: John G. M. Robertson: "Re: ruptured membranes and Shirodkar"

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