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Re: Labor epidrual and Chorio From: charlie chambers (cchamber@mnic.net) Sun Oct 31 11:35:58 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: William Camann: "Re: Labor epidrual and Chorio" Previous message: Paul Prior MD: "Re: Labor epidrual and Chorio" In reply to: Mark G. Newman: "Labor epidrual and Chorio" Next in thread: Suzanne S. Powell: "Re: Labor epidrual and Chorio" Reply: Suzanne S. Powell: "Re: Labor epidrual and Chorio" on 10/31/99 10:12 AM, Mark G. Newman at mgnewman@flash.net wrote: > Dear Listpersons: > > Please render some opinions about a situation that arose recently at one of > the hospitals I practice in... > A young woman was transferred to my institution with preterm PROM at 33+5 > weeks. On arrival, she was contracting, had a temperature of 100.7, and had > mild uterine tenderness. The diagnosis of chorioamnionitis was made, and > broad spectrum antibiotics and pitocin was begun. At cervical exam of > 3/100/-1, the patient requested epidural anesthesia for labor pain. The > anesthesiologist refused, stating that the patient had chorio, and thus > epidural was contraindicated. A second, backup anesthesiologist also > refused for the same reason. > > Am I missing something? > The literature says nothing about chorio as a contraindication to epidural, > only local infection at the site of puncture. > > Any others with experience or opinions? > > Mark G. Newman, MD > Perinatal Associates of Texas > as to the epidural, when I trained in Utah this was a common response from anesthesia though with little if any data to support this approach. it's frustrating but not much could be done. in addition, they were hesistant to place epidurals with anyone with pre-eclampsia especially sever. with regards to the hepatitis patient, possibly the provera caused but much more likely she may an underlying hepatic disorder. to be thorough, I would test her for viral hepatitis and follow her transaminases. if still no other explanation, then would assume the provera was responsible. especially check hep C, patients are very succeptible to "flares" after meds or surgery. -- ############################################################################ 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 ############################################################################ Next message: William Camann: "Re: Labor epidrual and Chorio" Previous message: Paul Prior MD: "Re: Labor epidrual and Chorio" In reply to: Mark G. Newman: "Labor epidrual and Chorio" Next in thread: Suzanne S. Powell: "Re: Labor epidrual and Chorio" Reply: Suzanne S. Powell: "Re: Labor epidrual and Chorio"

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