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Re: ACOG and labor inductions.From: Larry Glazerman (glazerman@enter.net)Sun Nov 30 17:48:32 1997
>Thanks for the reference, Dr. GLazerman. I don't have it at hand, but >one of the committee opinions or technical bulletins DOES expressly >allow for "elective" inductions at 39 weeks, assuming excellent >dating.It might be in the same one you referenced. A favorable Bishop >score is intuitive. > >Here's a point that Tom Garite recently brought up at a recent >conference,(I didn't get the original study from him)... that induction >alone is a high correlation for unneseccary C/Sections. Of course, >logically, medical inductees might be itself a high risk for C/S, but >Garite extrapolated for elective inductions as well. In conversation >with him, I related that was not my personal (anectdotal) experience, >and am reviewing my last 100 inductions to prove it. I still do not feel >that, in my own practice, induction per se raises the chance of C/S. My >own C/S rate has fallen for the past 3 years, and my induction numbers >have risen. I do a lot of inducing electively as well. > >Speaking of ACOG, Could anyone help me get BACK in to the ACOG site??? I >lost my username and password from two years ago, and for the past >several months, ACOG has resisted my attempts to re-enter, even with new >registration attempts. They never answer email. > >ALso, I could use the latest Technical bulletin on Group B Strep, if any >one could email me a copy. Thanks in advance, > >Ed Shackeroff,MD, FACOG (sans password) >Los Alamitos,CA > >Larry Glazerman wrote: >> >> In response to several messages about ACOG's stand on labor induction, >> I am quoting (I hope legally, with proper attribution) from ACOG >> Technical Bulletin #217, December 1995: >> >> I would interpret this statement to NOT preclude or prohibit >> "elective" induction, i.e., "An induction >> >performed only for the convenience of the Mother or the Physician". >> >> What do other members think> >> >> Larry R. Glazerman, M.D. FACOG >> Valley Ob-Gyn Associates >> Allentown PA >> glazerman@enter.net We often discuss the issue of induction per se raising the CS rate. I would agree that it would intuitively make sense that in the universe of patients whose labors are induced, the CS rate is probably higher. It would also intuitively make sense, though, that a multip with a very favorable cervix, being induced "electively", should not have a higher incidence of CS. I also wonder whether the use of cervical ripening agents helps (I think it does.)
-- Larry R. Glazerman, M.D. FACOG Valley Ob-Gyn Associates Allentown PA glazerman@enter.net
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