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Re: Previous stillbirthFrom: RModugno@aol.comTue Jun 30 21:20:33 1998
In a message dated 98-06-30 20:43:15 EDT, you write:
<<
>Dear list members: Just to be the devil's advocate.( It's OK, I'm old enough to withstand the flames and I'm totally unencumbered by data, and have the audacity to act on gut feeling and experience of previous stillbirth and all modern methods of fetal surveillance saying "everything's OK" and still having a repeat unexplained stillbirth near term), I would go so far as to probably start fetal surveillance at 34-36 weeks, and think about induction after 37 completed weeks depending on cervical status. I would definitely NOT go beyond 40 weeks and would use cervical ripening agents if necessary BECAUSE all the best advice from reputable perinatologists and all the evidence-based medicine in the World, is small consolation to someone who has lost a second child. I think a cesarean section for failed induction ( which would be unlikely) is a small price to pay for a live child. There you go! Total emotion! No science! Let the flames begin! ( And last but not least I would actually involve the patient in the decision-making - what a concept!) Robert Modugno MD FACOG Premier Medical OB/GYN Roswell, Ga.
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