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OB: Management PleaseFrom: Geffrey Klein (GK6972@americanmed.com)Tue Apr 28 12:05:25 1998
Requesting opinions: 22 y/o G1 today is 38 2/7 wks by 9 wk CRL. Pt is gestational diabetic class A2 on 8 U of insulin a day with good control (hgba1c = 6) . She was placed on insulin by perinatology due to some elevated postprandial glucose measurements on diet only. Fetal monitor has been reactive each week. US was done on 4/24 for S>D was 3569g and 90% for EGA of 37.8 wks. AFI was 13.2. Placenta is anterior. Interestingly, her platelet count, which was 178K on first visit, is now 100K. PIH has been ruled out. 24 hr urine this week was 100mg and all other biochemical data is within normal limits. BPs are all normal. Her cervix is FT dialted thick and high. She is cephalic. Management suggestions? A) Tap and induce if mature L/S and PG. B) Induce regardless. C) Continue with antenatal testing and allow her to go into spontaneous labor. D) Other Geffrey H Klein, MD Dept OB-GYN MacGregor Medical Association 2200 Nasa Road 1 Suite 200 Houston, Texas 77058 (713) 741-2273 ext. 2628 geffrey.klein@obgyn.net
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