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C-Section vs. Induction In Suspected Head/Pelvis Disproportion Cases

From: lauren (anonymous@obgyn.net)
Tue, 13 Apr 1999 14:19:17 -0500 (CDT)


I am a small-boned woman in my second pregnancy. In the first pregnancy, I gave birth to a 7 lb, 5 oz boy at 41 weeks after a protracted (18-hour) and distressed delivery that involved vacuum extraction. My son is fine now, but he did spend his first 3 1/2 days in NICU and then under the bili lights (due to jaundice caused by bruising from the vacuum). It was always suspected that I would need a c-section due to the fact that the baby had not dropped even after I had dilated to 7 cm and because from the way my uterus felt, the OBs in my practice all believed that the baby could have been as much as 9 lbs (I was scheduled for an ultrasound on the day I ended up delivering).

Now I am at 34 weeks, and at my most recent check-up, my OB told me that it appears that this baby will be even larger and that I am already measuring full term. We KNOW that my due date is correct because it is not based on LMP but on a series of ultrasounds performed at 5, 6, 9, 17 weeks and 20 weeks.

My OB does not really want to address the possibility of induction unless my cervix starts to show signs of ripeness (which it did not in my entire pregnancy last time). Instead, he will send me for an ultrasound at 38 weeks and consider the size of the baby and whether I should simply be scheduled for a c-section.

What is the current OB wisdom on induction vs. c-section in possible disproportion cases?




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