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Cesarea programada?From: Raul Dorbecker (raul_dorbecker@compuserve.com)Sun, 10 Aug 1997 14:42:34 -0400
Una cesarea programada solamente la realizo cuando existe una indicacion, como una desproporcion feto-pelvica, placenta previa, dos o mas cesareas anteriores, situacion transversa del feto, embarazo gemelar, etc. Hay que evitar el nacimiento de un feto prematuro, realizando una muy buena historia clinica, apoyada en ultrasonido y si existiera duda, estudio del liquido amniotico para relacion de lesitina/esfingomielina (>2) o simplemente prueba de la espuma (Clements), amnioscopia o esperar al inicio del trabajo de parto. Raúl. Dr. Raúl Dorbecker. Ginecología y Obstetricia Práctica Privada Ciudad de México MEXICO E-Mail: raul_dorbecker@compuserve.com URL: http://ourworld.compuserve.com/homepages/raul_dorbecker _____________________________________________________
_____________________________________________________ Geffrey H. Klein, MD wrote: > A woman with a prior cesarean section who has already been counseled > regarding trial of labor or repeat cesarean section has decided to > have a repeat cesarean section. If I don't agree with that decision, > I have a choice of allowing her to go into labor. > > This is paternalism. Geff- Agreed, and it's also bad medicine. The outcome for c/sections performed after labor starts is generally worse than for those performed before the onset of labor. While I have had patients who decide on an elective repeat c/section then come in prior to the scheduled procedure in labor and happily deliver vaginally, there are others who come in with ruptured membranes, at 5cm, who demand a c/section. The chance of chorioamnionitis, atony, etc. rises when c/sections are performed after labor begins. So, after she makes "the call" and decides on a repeat c/section, I schedule it per ACOG guidelines as close to 39 weeks as possible. Ashley D. Ashley Hill, M.D. Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Qual a opiniao dos colegas? E qto ao aspecto maturidade fetal?
Voltar para Administrador da lista: flavio.monteiro.desouza@obgyn.net Solicitações à lista: obstet-l-request@obgyn.net Última atualização: Mon May 19 16:35:17 2008 |
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