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 Classic C section!  



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Author5 Posts
  #1

Hey,

Couldnt find the gynae forum so thought would post it here.

1. What are the indications for performing the Classic C section?

2. How will you manage PROM....<30 wks gestation, 30-34 wks gestation and > 34 wks gestation.....Mother has no fever and no uterine tenderness and no uterine contractions?

Hope if someone is doing an internship in gynae....maybe he could help.

Salman




  #2

1-Indications for classic cs include Anteriorly implanted lowlying placenta,cervical cancer,myoma over the lower uterine segment,LUS varicosities,inaccesible LUS due to adhesions and thinned LUS due to obstracted labour.
2-PROM managment
GA <26 Termination of pregnancy
GA 26-34 oral penicillin and erythromycin,cervical sample culture,fetal maturity induction if GA is < 32 and careful follow up for fever ,uterine tendeness,ESR and CRP.
GA >34 Asess fetal lung maturity by amniocenthesis and induce labour if fetal lung is mature(that is L/S ratio >2.5)


  #3

agree plus b/n 26 n 32 n sometimes even upto 34 weeks give betamethasone which will take effect in 24 hrs so dlivery can be conducted if any s/s of chorioamnionitis. and i think lung is conidered to be matured in 34 weeks(controversy with 36 weeks)so deliverycan be conducted...


  #4

Very nice son64,

However about the management of PROm for <26 wks, Dont you think we should do serial Ultra sounds to determine the AFI and fetal testing...and if AFI < 3, then go ahead with TOP, otherwise treat conservatively.....Its just a thought, I guess you are right....

Salman


  #5

i got 66 percent right in kaplan usmle simulated test and about to appear in exam in august just in a few days can u give me ur opinion about the performance





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