Re: Post Partum D and C's for retained placenta- Thanks Greg
From: Joanne Simich (jmsmed58@hotmail.com)
Tue Jan 6 18:49:37 2004
Hi Greg
Thank you for writing regarding this case. I appreciate the input.
Regards
Joanne
At Wed, 7 Jan 2004, Greg Kesby wrote:
>
>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
>
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> -----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
