Re: RCT supports expectant management 42 wks
From: art fougner, md (evsono@pipeline.com)
Sat Dec 26 10:39:34 1998
and now for something completely different - try using in the
denominator of perinatal mortality, the number of patients remaining
UNDELIVERED instead. when you do this, mortality rises beginning after
38+ wks and keeps climbing.
i know, i know - not evidenced based and probably not a valid
statistical exercise but it is still food for thought.
Art
At Sat, 26 Dec 1998, Pat Sonnenstuhl wrote:
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>In my learnings, term is 40 weeks. 37 weeks is the point at which, if
>the baby were born, the baby would be well formed. If 37 weeks were
>term, then we'd feel the two weeks before that would be a normal range.
>that puts us at 35 weeks, when many babies still have problems. Upon
>what do you base your definition.
>
>RModugno@aol.com wrote:
>>
>> << >Mine can be expressed as follows: I believe in fetal testing and am
>> >willing to test these patients beginning at 41 weeks' gestation and
>> >until they are truly post-term, that is 43 weeks. At that time , I
>> >consider labor induction with intravaginal misoprostol (50 mcg q'3-4
>> >hrs). Some of my partners (MFMs) opt for an earlier induction. Of
>> >course, I can be flexible, and if a given patient is 42 weeks' gestation
>> >with a very favorable cervix, I can go along with an induction.
>> >Certainly, the policy changes with patients that have other problems
>> >i.e, chronic hypertension, diabetes, etc. We also encounter
>> >difficulties with the often-seen patient who has "uncertain" dates. I
>> >personally am of the opinion that inducing patient's at 41 week's
>> >gestation is unnecessary. Remember, term is defined as 40 weeks plus or
>> >minus 2 weeks.
>> >Anyway, this is an interesting and controversial subject. We need to
>> >keep discussing it. >>
>>
>> Just to be the devil's advocate, I thought that term was defined as 37
>> completed weeks.
>>
>> Robert Modugno MD FACOG
>> Marietta GA
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