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Re: Post Partum D and C's for retained placentaFrom: Greg Kesby (greg.kesby@sufw.com.au)Tue Jan 6 15:21:24 2004
As an Aussie sonologist and MFM, what you describe is pretty standard (and in my view good) practice. We are a little more conservative with regard the use of curettage. While aware of the limited utility of sonography in the setting of RPOC 2 weeks postpartum, we use it to ensure that there is not a large amount of RPOC. Then, in the setting of a confirmed small volume or none sonographically evident, antibiotics and "let nature take its course" is a very common practise. Her management sounds excellent.....avoided a GA and curette with its possible associated morbidity and just had to put up with passing a small amount of placenta 2 weeks post partum. Cheers Greg CONFIDENTIALITY NOTICE: This information in this e-mail is intended for the named recipients only. It may contain privileged or confidential information. If you are not an intended recipient, you must not copy, distribute, or disclose any details to any person, firm or corporation. If you have received this e-mail in error please contact smee@sufw.com.au <mailto:administration@sufw.com.au> immediately. -----Original Message----- From: jmsmed58@hotmail.com [SMTP:jmsmed58@hotmail.com] Sent: Wednesday, 7 January 2004 8:54:AM To: Multiple recipients of list ULTRASOUND Subject: Post Partum D and C's for retained placenta Hi I would like to know pracitioners opinion on the value of doing an ultrasound if a patient has passed Is the ultrasound examination going to pick up small amounts of retained products? If it isnt then why not just do a D and C. This particular patient had some retained placenta. A small amt discharged 2 weeks post partum. She called the hospital who did the delivery and they said get some antibiotics. Not being happy with that she went to a local GP (In Australia they are M.D's) and the following was done: vaginal swab, an ultrasound was ordered and antibiotics were prescribed to be taken before the results of ultrasound came through. A possiblity of a D and C was mentioned at the time of appointment. So, having said what this person's history is, how valuable is the ultrasound going to be? Shouldnt this doctor just go ahead and order a D and C without further ado? Looking forward to your replies Regards Joanne
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