Anencephaly even at term pregnancy the small foetal head
cones out through undilated say 5-7 cm dilation and then Cx refuses to dilate.
In this case as because there is scar in uterus all doctors will be worried about risks
associated with cleidotomy à Rupture uterus about of destructive operation Cleidotomyà division of one or both foetal clavicles, Dear members remember
that bisacromial diameter is the largest diameter of foetus than brow. –This
is applicable both for term as well as very preterm as is in this case... As
such Mifegest followed by à Misoprostol / Foley induction os OK but to keep a vigil on rupture
uterus out of in foetal manipulation which is a distinct possibility in this case.
It is impossible that Cx will dilate by Misoprostol / Foley alone. By that I don’t
mean that one should go for elective CS but I shall agree with the other
members of surgical induction but A) Counseling
should be done about laparotomy B) Blood –PCV I unit & Anesthetist
must be alerted whenever labour pains commences. C) Even if cleidotomy becomes
unnecessary still she Badly warrant exploration of uterus is a must in this
case.
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