Re: PPROM-17.6 weeks, B/G Twins
From: Alicia M. Lapidus M.D. (anonymous@obgyn.net)
Thu, 29 Aug 2002 19:35:11 -0500 (CDT)
Of course you are sad, but your babies didn't have much of a chance with
a PPROM at 18 weeks and if with a very slim chance of survival the
morbidity of any kind would have been close to 99.99%. Sorry.
At Thu, 29 Aug 2002, Michelle wrote:
>
>Dear Doctor,
>
>I am healthy and 28. My husband has azoospermia, 1st IVF this past
>year. We conceived twins. Had brown spotting at 7 wks for one day and
>then some pinkish spotting at 10wks 4 days.
>
>At 17.6 wks, I woke with a gush of water. Confirmed amniotic fluid thru
>"ferning" test and US--US showed 2 otherwise healthy babies--but Twin A
>with 2.3CM of fluid, cervix closed and 3CM,no signs of infection,
>negative for GBS & trich. Had 2 peris in the hospital. Both peri's
>said 80% chance of mortality for both twins (despite dichorionic and
>diamniotic) since the same uterus. One of the peris focused much more
>on mortality and morbidity risks and deliverying in the "gray period"
>24-28 wks. The other said "you have a chance of one healthy baby,
>though the odds are stacked against you but if you can just stay
>pregnant till 28 wks you may be ok; also said that " he had a gut
>feeling maybe I would be one of the ones to make it, though many don't
>".We are conservative people who kept thinking if our babies were going
>to suffer then how could be proceed with the informed consent?
>
>At 20 wks we ended the pregnancy and I am devastated to the core of my
>being.
>
>I am still in shock and it has been 6 wks. I keep wondering if the
>doctors were right and the babies really did not have much of a chance.
>What do you counsel your patients in this type of situation? Do you tell
>them you have a "gut feeling" they could make it? What is the general
>concensus of prom at previability in the medical community? This is
>haunting me.
>
>Sorry so long, but so sad.
--
Alicia M. Lapidus M.D.
Chief of Staff Obstetrics, Hospital Fernández
Assistant Professor, School of Medicine, Barcelo University
Vicepresident of Argentine Society of Hypertension in Pregnancy
Director Latina Obgyn.net- http\latina.obgyn.net\espanol
Buenos Aires
Argentina
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