Questions related to Fetal Medicine
Unbooked primigravida diagnosed with diabetes mellitus of 3 years duration and defaulted on taking her medication, presented with IUGR, was delivered of female infant of 1.7 kg at term. The mother has no renal pathology and the baby has no congenital anomaly.
During caeserian section for obstructed labour with impacted fatal head, is it safer and easier to pull the fatal head from above to ask an assistant to push from below through the vagina?
Recent UK guidance advocates use of the ductus venosus in the timing of delivery of the growth restricted fetus. Ductus venosus doppler has a moderate predictive accuracy for determining peri-natal outcome. We are awaiting the official results from TRUFFLE which will hopefully offer further guidance. Additionally many obstetricians are not trained in the acquisition of this doppler and correct acquisition is vital for interpretation and management. Hence, what is the consensus; should we use it? The evidence seems to say so, but what implications does this have for the layout of obstetric care and in reality are obstetricians using it as a tool to time delivery?