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Re: OB: My case list...From: Geffrey H. Klein, MD (gklein@ICSI.Net)Sat May 30 12:10:15 1998
On 5/30/98, Dr Eberhard W Lisse wrote this: Q> I would have booked her for elective Vaginal Bypass and BTL at 38/40, Q> I would not have allowed trial of scar: Q> Q> 1) She neded to be opened for BTL anyway Q> 2) Previous Cesarean was for failed induction Q> 3) Baby was largish in a functional primipara, we haven't been told Q> andything about the position. Occipito Posterior? Right or Left? Q> 4) PIH to Pre-Ecclampsia, we haven't been told about the FBC and Q> coagulation studies. Q> 5) We are not HMO run, in other words: I CAN :-)-O Hmm.. 1) L-scope BTL or pp BTL are less morbid than elective repeat cesarean 2) True... But still had a chance to deliver vaginally.. by some research 50% at worst. 3) position OA 4) sorry, FBC is unfamiliar abbreviation to me.. all of her biochemical parameters regarding renal, hematologic, and hepatic function were normal.. 5) For me it is not a matter of payer, but rather patient choice. It would be not be unreasonable for either approach depending on patient desire. Q> >>SROM occurred and internal monitors were Q> >>placed. Q> Q> How far was she dilated when you did that or what was the Bishop's Q> score? Not that it matters, just out of interest. Her cervix was 1-2 cm dialted and the fetal head was at a minus 2/3 station. The cervix was 40-50% effaced, soft, and midposition. Q> Just one more question, how much Oxytocin or Oxytocin/Ergometrin was Q> given at C/S, when exactly, and did you put any Oxitocin in the drip? Per the anesthesia protocol 20 U pitocin is added to 1 liter of crystalloid and infused intravenously after the birth of the baby. ---------------------------------- Geffrey H. Klein, MD ---------------------------------- gklein@bcm.tmc.edu -- ---------------------------------- List-owner OB-GYN-L
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