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Re: Previous stillbirth From: Garry E. Siegel, M.D. (garrys@mindspring.com) Tue Jun 30 21:53:37 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Mary Shoup: "This Week in Chat July 2 - 8" Previous message: RModugno@aol.com: "Re: Previous stillbirth" In reply to: RModugno@aol.com: "Re: Previous stillbirth" Dr. Modugno obviously missed his antipsychotic tonight. However, I agree with testing, *possibly* adding a late ultrasound to look for a nuchal cord (and what you do with that is a real problem--pre ultrasound counseling a must!). I would tend to wait until 38 weeks, and wouldn't hesitate to ripen and induce. Garry > >> >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. -- Garry E. Siegel, M.D., FACOG Private Practice Roswell, Ga. Next message: Mary Shoup: "This Week in Chat July 2 - 8" Previous message: RModugno@aol.com: "Re: Previous stillbirth" In reply to: RModugno@aol.com: "Re: Previous stillbirth"

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