NYTimes op-ed on bed rest in obstetrics

[lilycat]

---

Members don't see this ad.

http://www.nytimes.com/2006/03/24/opinion/24bilston.html?_r=1&oref=slogin

The above is a link to an op-ed published today in the New York Times criticizing the use of bed rest in obstetric complications and complaining about a lack of studies showing its efficacy.

Thought some of you might find it interesting. Now I feel the need to do some PubMed searches. 😀

 

[Diane L. Evans]

http://www.nytimes.com/2006/03/24/opinion/24bilston.html?_r=1&oref=slogin

The above is a link to an op-ed published today in the New York Times criticizing the use of bed rest in obstetric complications and complaining about a lack of studies showing its efficacy.

Thought some of you might find it interesting. Now I feel the need to do some PubMed searches. 😀

There are no studies because doing so would be unethical. Think about it pretem labor 26weeks with bulging mebranes at 5 cm dilitation bed rest vs no bedrest does it seem ethical? NO...
We all have seen the 26 weeker with bulging membranes placed in reverse trendenburg with tocolysis get to 27 /over weeks and have the advantage of betamethasone/dex for FLM. Also walking is known to stimulate labor by placing pressure on the cervix and releasing prostaglandins. They're right OB literature is very data poor.

Just my 2 cents
D

 

[ilovepubmed]

There are no studies because doing so would be unethical. Think about it pretem labor 26weeks with bulging mebranes at 5 cm dilitation bed rest vs no bedrest does it seem ethical? NO...
We all have seen the 26 weeker with bulging membranes placed in reverse trendenburg with tocolysis get to 27 /over weeks and have the advantage of betamethasone/dex for FLM. Also walking is known to stimulate labor by placing pressure on the cervix and releasing prostaglandins. They're right OB literature is very data poor.

Just my 2 cents
D

MFM's have told me (I haven't checked personally) that studies have shown that people in occupations involving prolonged standing have higher incidences of preterm birth.

 

[Doc Zuzu]

Twelve weeks in bed rarely killed a pt, that I know of. (Not all that worried about blood clots in otherwise healthy women of childbearing age. most get up to poop anyway, that may be enough exercise.) It may well have saved many a babe.

Did twelve or more weeks bedrest myself, several times. Probably saved my kids from many weeks NICU time. Not great for your career, but good for your babe. IMNSHO, babe is more important.

If there were a study with a control group being done, just who would decide which pts would be in the "Go ahead and go back to waitressing, with those 6 per h. Contractions, 4 cm dil. 80% effaced, engaged fetal head, and 16 weeks till EDD, while we exercise 'watchful waiting'" group? I wouldn't want to be responsible for that particular trainwreck. 😱

 

[Doc Zuzu]

"NO, bedrest doesn't mean working 30 hours a week instead of 40. It doesn't mean 'since I'm home, I may as well move the furniture and paint the nursery and put the crib together,' It doesn't mean, "Field trip time for the other kids." It doesn't mean, "We can have sex, as long as we're "careful."" It doesn''t mean, "May as well cut the grass, since I'm just sitting around." Bedrest means BED (or couch) rest.

One of my pet peeves, all those babes in the NICU who maybe could have been near term. because someone didn't understand the meaning of the two simple words "bed" and "rest." *sigh*

 

[tiredmom]

It doesn't mean, "We can have sex, as long as we're "careful."" QUOTE]

This reminds me of a patient I had years ago in my nursing days. In for preterm labor, doctor (one of the old guard) asks patient if she had been on pelvic rest as they had discussed earlier in the month. She replied "well... We haven't had any intercourse per say, at least any penetration". To see the old doctor blush was priceless!