OB-GYN-L Messages for October, 1999: Re: OB-GYN-L digest 624

Re: OB-GYN-L digest 624

From: Dr. Strahimir Banović

strahimir.banovic@zg.tel.hr

Thu Oct 28 14:58:54 1999

> OB-GYN-L Digest 624
>
> Topics covered in this issue include:
>
> 1) twin delivery when ceph/breech
> by "Orlando Caruso" <carusorl@tin.it>
> 2) Re: twin delivery when ceph/breech
> by RModugno@aol.com
> 3) Re: twin delivery when ceph/breech
> by RModugno@aol.com
> 4) Re: twin delivery when ceph/breech
> by charlie chambers <cchamber@mnic.net>
> 5) Acutane
> by Larry Glazerman <l.glazerman@rcn.com>
> 6) Re: FRI Eggs for auction.
> by "Rafael Haciski MD" <haciski@earthlink.net>
> 7) I WARNED YOU ONCE ALREADY
> by "companyexpress@hotmail.com" <companyexpress@hotmail.com>
> 8) FW: CROSS-POST[Ovary-Science] egg donation and mirena IUS
> by "Jeffrey W. Clemens" <clemens@duq.edu>
> 9) Texas conference in December
> by rjewell@bigpond.com (Dr Ron Jewell)
> 10) Re: twin delivery when ceph/breech
> by Steve <Steve@dhngwe2.db.healthlink.org.za>
>
> ----------------------------------------------------------------------
>
> ----------------------------------------------------------------------
> Date: Wed, 27 Oct 1999 21:25:20 +0200
> ----------------------------------------------------------------------
> From: "Orlando Caruso" <carusorl@tin.it>
> To: <ob-gyn-l@obgyn.net>
> Subject: twin delivery when ceph/breech
> Message-ID: <01bf20b1$02a60c40$0100007f@ocarus>
> MIME-Version: 1.0
> Content-Type: text/plain;
> charset="iso-8859-1"
> Content-Transfer-Encoding: 7bit
>
> In my dept. there are different opinion in delivering twin at term with
> cephalic/breech presentation.
> Elective CS/ vag. delivery?
> Which is the menagement in your hospital?
>
> Thanks 4 your suggestions.
>
> Orlando Caruso, MD
> Ospedale di Seriate - Bergamo
> Italy
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 27 Oct 1999 16:33:36 EDT
> ------------------------------
> From: RModugno@aol.com
> To: ob-gyn-l@obgyn.net
> Subject: Re: twin delivery when ceph/breech
> Message-ID: <0.45ad87bd.2548bba0@aol.com>
> MIME-Version: 1.0
> Content-Type: text/plain; charset="us-ascii"
> Content-Transfer-Encoding: 7bit
>
> In a message dated 10/27/99 3:45:33 PM Eastern Daylight Time, carusorl@tin.it
> writes:
>
> << In my dept. there are different opinion in delivering twin at term with
> cephalic/breech presentation.
> Elective CS/ vag. delivery?
> Which is the menagement in your hospital?
>
> Thanks 4 your suggestions.
>
> Orlando Caruso, MD
> Ospedale di Seriate - Bergamo
> Italy >>
>
> Each case should be assessed on individual factors. If the second twin has
> been accurately assessed, and is not substantially larger than the first,
> then I see no reason not to attempt a vaginal delivery. External cephalic
> version may be attempted after delivery of the second twin, and/or delivery
> by breech extraction. Epidural anesthesia is the ideal method.
>
> I recently helped two younger colleagues do just that - that's what happens
> when your an old fart obstetrician.
>
> My 2 cents.
>
> Robert Modugno MD FACOG
> Marietta, GA
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 27 Oct 1999 16:45:24 EDT
> ------------------------------
> From: RModugno@aol.com
> To: ob-gyn-l@obgyn.net
> Subject: Re: twin delivery when ceph/breech
> Message-ID: <0.3ae404f0.2548be64@aol.com>
> MIME-Version: 1.0
> Content-Type: text/plain; charset="us-ascii"
> Content-Transfer-Encoding: 7bit
>
> In a message dated 10/27/99 4:35:57 PM Eastern Daylight Time,
> RModugno@aol.com writes:
>
> << External cephalic
> version may be attempted after delivery of the second twin, >>
>
> Sorry, I meant first!
>
> Robert Modugno MD
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 27 Oct 1999 17:02:19 -0500
> ------------------------------
> From: charlie chambers <cchamber@mnic.net>
> To: <ob-gyn-l@obgyn.net>
> Subject: Re: twin delivery when ceph/breech
> Message-ID: <B43CE09B.76%cchamber@mnic.net>
> Mime-version: 1.0
> Content-type: text/plain; charset="US-ASCII"
> Content-transfer-encoding: 7bit
>
> on 10/27/99 2:45 PM, Orlando Caruso at carusorl@tin.it wrote:
>
> > In my dept. there are different opinion in delivering twin at term with
> > cephalic/breech presentation.
> > Elective CS/ vag. delivery?
> > Which is the menagement in your hospital?
> >
> > Thanks 4 your suggestions.
> >
> > Orlando Caruso, MD
> > Ospedale di Seriate - Bergamo
> > Italy
> >
> assuming concordant growth, i prefer to deliver vaginally with complete
> breech extraction of the second twin.
>
> --
> ############################################################################
>
> Charlie Chambers, MD "No matter where you go...
> Owatonna Clinic-Mayo Health Systems there you are."
> cchamber@mnic.net
> chambers.charles@mayo.edu Dr. Buckaroo Banzai
>
> ############################################################################
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 27 Oct 1999 20:40:44 -0400
> ------------------------------
> From: Larry Glazerman <l.glazerman@rcn.com>
> To: ob-gyn-l@obgyn.net
> Subject: Acutane
> Message-ID: <4.2.0.58.19991027203931.00aeb450@pop.rcn.com>
> Mime-Version: 1.0
> Content-Type: text/plain; charset="us-ascii"; format=flowed
>
> I have a patient currently about 6 weeks pregnant, who took Acutane, and
> stopped it anywhere from 5 days prior to conception to possibly the day of
> conception. The one paper furnished by the manufacturer suggested very
> little risk of problems in this scenario.
>
> Anyone have any personal experience here?
>
> Thanks
>
> Larry Glazerman
> Larry R. Glazerman, MD
> Ob-Gyn at Trexlertown
> 610-402-0161
> l.glazerman@rcn.com
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 27 Oct 1999 21:20:03 -0400
> ------------------------------
> From: "Rafael Haciski MD" <haciski@earthlink.net>
> To: ob-gyn-l@obgyn.net
> Subject: Re: FRI Eggs for auction.
> Message-ID: <199910280120.SAA21836@gull.prod.itd.earthlink.net>
> Mime-version: 1.0
> Content-type: text/plain; charset="US-ASCII"
> Content-transfer-encoding: 7bit
>
> No I think that's what the nuns told us!
>
> Rafael Haciski, MD FACOG
> Gynecology & Infertility Associates
> Baltimore MD
> http://www.ivf-md.com
>
> ----------
> >From: DoctorJoe@aol.com
> >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@talk.obgyn.net>
> >Subject: Re: FRI Eggs for auction.
> >Date: Tue, Oct 26, 1999, 21:05
> >
>
> >
> > In a message dated 10/26/99 2:05:43 PM, haciski@earthlink.net writes:
> >
> > << ..ejaculation through mastrubation is quick, easy, painless, and without
> > medical complications (ie.: risk to donor's health and well being); >>
> >
> > Hey, I thought it made you blind, simpleminded, and grew hair on your palms?!?
> >
> > Joe P.
> >
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 27 Oct 1999 22:46:28 -0500
> ------------------------------
> From: "companyexpress@hotmail.com" <companyexpress@hotmail.com>
> To: <ob-gyn-l@obgyn.net>
> Subject: I WARNED YOU ONCE ALREADY
> Message-ID: <199910280247.WAA72193@smtp.stratos.net>
> MIME-Version: 1.0
> Content-Type: text/plain; charset=us-ascii
> Content-Transfer-Encoding: 7bit
>
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> ------------------------------
>
> ------------------------------
> Date: Thu, 28 Oct 1999 08:28:16 -0400
> ------------------------------
> From: "Jeffrey W. Clemens" <clemens@duq.edu>
> To: ob-gyn-l@obgyn.net
> Subject: FW: CROSS-POST[Ovary-Science] egg donation and mirena IUS
> Message-ID: <199910281228.IAA16497@mail.cc.duq.edu>
> Mime-version: 1.0
> Content-type: multipart/alternative;
> boundary="MS_Mac_OE_3023944096_425748_MIME_Part"
>
> > THIS MESSAGE IS IN MIME FORMAT. Since your mail reader does not understand
> this format, some or all of this message may not be legible.
>
> --MS_Mac_OE_3023944096_425748_MIME_Part
> Content-type: text/plain; charset="US-ASCII"
> Content-transfer-encoding: 7bit
>
> Listers,
>
> Can anyone help this person out? Inquiry was posted to the ovary-science
> list. Please respond to that list or Jonathon directly, NOT TO ME. I have
> no other info. about this individual.
> --
> Jeffrey W. Clemens, Ph.D.
> Assistant Professor, Biological Sciences
> Duquesne University
> Pittsburgh, PA 15282
> 412-396-4597
> fax-5907
> http://www.home.cc.duq.edu/~clemens/
>
> ----------
> From: "Jonathan" <jonathan.skull@lineone.net>
> To: <ovary-science@nottingham.ac.uk>
> Subject: [Ovary-Science] egg donation and mirena IUS
> Date: Wed, Oct 27, 1999, 6:26 PM
>
> I have a lady who wants to act as an altruistic anonymous egg donor, but has
> a Mirena IUS fitted for both contraception and mennorrhagia. It has been in
> situ for 5 months and is providing excellent cycle control.
>
> My question is "should this be removed before attempting superovulation".
> The easy answer would be "yes" and replace it afterwards. However, I am
> reluctant for three main reasons:
> She requires good contraception
> She requires control of her periods and to have a recurrence of her bleeding
> problems may dissuade her from being an egg donor.
> The cost of replacement may have to be born by the General Practitioner, who
> having only just having put the coil in, may be none too pleased!
> However, I would not want to leave it in-situ if it could affect the
> response to superovulation or the quality of the oocytes and resultant
> embryos leading to decreased pregnancy rates in the recipient.
>
> Enquires to the manufacturer (Schering) reveal that serum levels of
> Levonorgestrel (LNG) reach maximum levels within a few hours of insertion
> and reach a plateau of 100-200 pg/ml after the first few weeks (Haukkamaa et
> al. 1996).
>
> I can find no literature on this subject and wondered if anybody else has
> had experience with this or has any advice.
>
> Many thanks
>
> Jonathan Skull
>
> --MS_Mac_OE_3023944096_425748_MIME_Part
> Content-type: text/html; charset="US-ASCII"
> Content-transfer-encoding: quoted-printable
>
> <HTML>
> <HEAD>
> <TITLE>FW: CROSS-POST[Ovary-Science] egg donation and mirena IUS</TITLE>
> </HEAD>
> <BODY BGCOLOR="#FFFFFF">
> Listers, 
> 
> Can anyone help this person out?  Inquiry was posted to the ovary-scie> nce list.  Please respond to that list or Jonathon directly, NOT TO ME.>  I have no other info. about this individual. 
> -- 
> Jeffrey W. Clemens, Ph.D. 
> Assistant Professor, Biological Sciences 
> Duquesne University 
> Pittsburgh, PA 15282 
> 412-396-4597 
> fax-5907 
> http://www.home.cc.duq.edu/~clemens/ 
> 
> ---------- 
> From: "Jonathan" <jonathan.skull@lineone.net> 
> To: <ovary-science@nottingham.ac.uk> 
> Subject: [Ovary-Science] egg donation and mirena IUS 
> Date: Wed, Oct 27, 1999, 6:26 PM 
> 
> <BLOCKQUOTE>I have a lady who wants to ac> t as an altruistic anonymous egg donor, but has a Mirena IUS fitted for both> contraception and mennorrhagia.  It has been in situ for 5 months and > is providing excellent cycle control.   
>   
> My question is "should this be remov> ed before attempting superovulation".  The easy answer would be &q> uot;yes" and replace it afterwards.  However, I am reluctant for t> hree main reasons: 
> <OL><LI>She requires good c> ontraception
> <LI>She requires control of her periods a> nd to have a recurrence of her bleeding problems may dissuade her from being> an egg donor.
> <LI>The cost of replacement may have to b> e born by the General Practitioner, who having only just having put the coil> in, may be none too pleased! 
> </OL>However, I would not w> ant to leave it in-situ if it could affect the response to superovulation or> the quality of the oocytes and resultant embryos leading to decreased pregn> ancy rates in the recipient. 
>   
> Enquires to the manufacturer (Schering) r> eveal that serum levels of Levonorgestrel (LNG) reach maximum levels within > a few hours of insertion and reach a plateau of 100-200 pg/ml after the firs> t few weeks (Haukkamaa et al. 1996). 
>   
> I can find no literature on this subject > and wondered if anybody else has had experience with this or has any advice.> 
>   
> Many thanks 
>   
>   
> Jonathan Skull 
>   
>   
> 
> </BLOCKQUOTE>
> </BODY>
> </HTML>
>
> --MS_Mac_OE_3023944096_425748_MIME_Part--
>
> ------------------------------
>
> ------------------------------
> Date: Thu, 28 Oct 1999 07:34:26 -0500 (CDT)
> ------------------------------
> From: rjewell@bigpond.com (Dr Ron Jewell)
> To: OB-GYN-L@OBGYN.net
> Subject: Texas conference in December
> Message-ID: <199910281234.HAA16317@talk.obgyn.net>
>
> I was sent a flyer about a conference over a weekend in December in San
> Antonio Texas which was basically about pelvic floor surgery. I know Dr
> Shull was one of the speakers.
>
> Unfortunately I have lost the information and can't track it down
> through ACOG.
>
> Can anyone please help?
>
> Thank you
> Ron Jewell
> rjewell@bigpond.com
>
> --
> rjewell@bigpond.com
>
> ------------------------------
>
> ------------------------------
> Date: Thu, 28 Oct 99 06:16:03 +0200
> ------------------------------
> From: Steve <Steve@dhngwe2.db.healthlink.org.za>
> To: "OB-GYN-L@OBGYN.NET" <OB-GYN-L%OBGYN.NET@db.healthlink.org.za>
> Subject: Re: twin delivery when ceph/breech
> Message-ID: <3258137147@p122.f99.n7106.z5.ftn>
> Mime-Version: 1.0
> Content-Type: text/plain; charset=iso-8859-1
> Content-Transfer-Encoding: 8bit
>
> > From: "Orlando Caruso" <carusorl@tin.it>
> >
> > In my dept. there are different opinion in delivering twin at term with
> > cephalic/breech presentation.
> > Elective CS/ vag. delivery?
>
> I agree with the two postings supporting vaginal delivery. Once the first twin
> is delivered any manipulation through the fully dilated cervix can be done that
> is necesssary to deliver the second. Internal version and breech extraction is
> a very saisfactory manoeuvre for any problem with the second twin in other
> presentations, thus cephalic/breech is an ideal situation to have, second only
> to cephalic/cephalic.
>
> Steve Raymond
> Head of O & G
> Empangeni Hospital
> SOUTH AFRICA
>
> ------------------------------
>
> ------------------------------
> End of OB-GYN-L Digest 624
> ------------------------------
> **************************

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