Re: labor induction at 41.5 wks vs expectant management

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• Reply: Cindy: "repeat question: progesterone levels"

No doctor should ever be too busy to discuss options and the risks and benefits of those options.

From our reading, we are thinking >perhaps waiting an additional week might be possible, with twice weekly
>checkups and daily at-home prostoglandin gel application on or near her
>cervix

Twicwe weekly checkup, with once or twice weekly NSTs (non-stress tests) and weekly fluid check by ultrasound would be reasonalble. Daily fetal movement counts should also be done and any change in hte baby's usual pattern ahould be immediately reported to your doctor.

As for the home prostaglandin gel, it not done, at least where I practice. Prostaglandins are wonderful at ripening the cervix, but should be applied in the hospital -- or at least in the office and hen baby is monitored for a while afterwards.In your wife's case, with the surgically scarred uterus from her prior c-section, I would advocte cervical ripening under close monitoring.

We are having difficulty deciding if this is a wise or a poor >decision. In addition, if we were to wait an additional week and labor
>did not progress, would it then be less risky(at 43.5 wks) to go
>straight to a C section?

You mean 42.5 (41.5 + one week)?? It depends on what her cervix is doing -- if dates are really good and her cervix is still unripe and the baby is not down in the pelvis, it might be better to just go ahead witha repeat c-section. Lots of factors have to be taken into consideration.

--
M. Kelly Shanahan, MD, FACOG
S. Lake Tahoe, CA

Replies are for educational purposes only and do not construe any doctor-patient relationship; they do not take the place of a face-to-face consultation with your own doctor.
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• Next message: Cindy: "repeat question: progesterone levels"
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• In reply to: bj: "labor induction at 41.5 wks vs expectant management"
• Next in thread: Cindy: "repeat question: progesterone levels"
• Reply: Cindy: "repeat question: progesterone levels"