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Re: OB: new casesFrom: Betsy Hyde (elishyde@connix.com)Fri May 28 20:41:22 1999
At 4:04 PM 5/28/99, Garry E. Siegel, M.D. wrote: >First case:
>Her AFI yesterday was 5, cervix 1-2/50%/-3, growth measurements 35.5 induce with miso. Has oligo, cervix is decent, and there is a weak suggestion of growth restriction (this is last on my list of reasons to induce).
>Second case: evidence is clear that induction for macrosomia results in increased c/s rate. She had a decent sized baby the first time, and I would not be worried re the EFW on this one. Her cervix is clearly unripe. Our practice does not do postdates inductions until 42 weeks, unless, of course, there is poor testing/decreasing AFI. Even at 42 weeks we only induce w/ a ripe cervix...which this clearly is not. If you want to induce her, I'd do miso first. Of course the issue of holiday weekend, and not being on call is a problem. If this were my situation, I might consider testing #1 and inducing when my group was on call. (Or, if my gut feeling said this baby needed out, I'd suck it up and do it.)
-- Betsy Hyde CNM Branford, CT
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