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Re: Post Partum D and C's for retained placenta- ultrasound result From: Philippe Jeanty (jeanty@TheFetus.net) Thu Jan 8 18:11:52 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Tom Kavic Direcpc: "Re: Post Partum D and C's for retained placenta- ultrasound resul t" Previous message: Greg Kesby: "Re: Post Partum D and C's for retained placenta- ultrasound resul" In reply to: Greg Kesby: "Re: Post Partum D and C's for retained placenta- ultrasound resul" I think that Greg's advice is very wise. It is an old Radiology axiom: treat the patient; not the image ! -----Original Message----- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of Greg Kesby Sent: Thursday, January 08, 2004 5:07 PM To: Multiple recipients of list ULTRASOUND Subject: Re: Post Partum D and C's for retained placenta- ultrasound result Treat the patient not the scan. At now (3-4 weeks) postpartum, if she is fine and happy with life and the trend is for things to be improving, I would leave her alone in the absence of a definite clump or RPOC 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: Friday, 9 January 2004 8:42:AM To: Multiple recipients of list ULTRASOUND Subject: Re: Post Partum D and C's for retained placenta- ultrasound result Hi Greg. This patient below went to get an ultrasound. The ultrasonographer could definitely see that there was still fluid and debris in the uterus.... How much she didnt say. The results from the ultrasound will be delivered to the Dr tomorrow. The per vaginal bleeding has really slowed down and is starting to look like its clearing up. So Greg, what would be your advice in this situation? Would you still go the conservative way? Interested to know what you think 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 > >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 Next message: Tom Kavic Direcpc: "Re: Post Partum D and C's for retained placenta- ultrasound resul t" Previous message: Greg Kesby: "Re: Post Partum D and C's for retained placenta- ultrasound resul" In reply to: Greg Kesby: "Re: Post Partum D and C's for retained placenta- ultrasound resul"

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