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Re: Chorioamnionitis: Question In response to Dr. Richard Chudacoff
From: Marcia (anonymous@obgyn.net)
Tue, 3 Nov 1998 10:59:51 -0600 (CST)
This is really interesting to me because at the practice I went to, the
cervix is not checked until you are admitted to the hospital, presumedly
in labor. At a larger hospital in a nearby city (more cosmopolitan, I
guess ;)), cervical checks are done for the last month or so as a matter
of course. I've heard so many women talk about getting them that I
thought that my OB's must be odd.
So, do you *not* do cervical checks, Dr. Chudacoff?At Tue, 3 Nov 1998,
Richard M. Chudacoff, MD wrote:
>
>At Tue, 3 Nov 1998, Melissa wrote:
>>
>>I read your discussion on incompetent cervix and the possibility of
>>chorioamnionitis. I am 19 weeks into my 3rd pregnancy. I delivered at
>>32 weeks due to premature rupture of membranes and I am wondering if
>>this infection could have caused this to happen and if I should request
>>that pelvic exams be performed at each Dr's visit to watch for cervical
>>dialation in this pregnancy. This also leads to my 2nd question: Do
>>cervical checks sometimes lead to premature labor? Please advise.
>>Thanks!
>
>It has been suggested that pregnant women be checked at each visit for
>BV (bacterial vaginosis). Although not a common practice at this point
>(I'll admit I am not fully set up to do this, and need to read some more
>studies to fully convince me) one suggestion is that the patient check
>the vaginal pH herself with Nitrazine paper at the same time they donate
>a urine sample. A pH greater than 4.5 suggests an infection and can be
>further investigated and treated. A pH less than 4.2 is highly
>suggestive of normal vaginal flora.
>
>I happen to believe that more exams can lead to infection, but I do not
>have any randomized controlled studies to prove this. It was impressed
>upon me during my training. Simple dogma. This is just my opinion,
>training and practice. But if I have a patient at high risk for
>pre-term labor or cervical incompetence, the exams are much less risky
>than a missed diagnosis, and I would exam the cervix for dilation and
>the vaginal for BV at each visit.
>
>--
>Richard Chudacoff, MD
>Baylor College of Medicine
>BaylorMedCare
>Houston/Sugar Land, TX
>
>Advisory Board-OBGYN.net
>http://www.obgyn.net/board/chudacoff.htm
>
>*Note: Opinions expressed here are for educational purpose only.
>This information is not intended to supplant the need for you to
>consult with your physician prior to choosing therapeutic options.
>
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