Sunday, January 4, 2015

What should I expect from my ultrasonologist?


Ultrasonologists and obstetricians  are having a unique relationship in private obstetric practice .It is time that they educate each other about many obstetric issues for the overall well being of the mother and baby. As an obstetrician in private practice  I feel that obstetricians and ultrasonologists are giving advice to patients independent of each other leaving the patient highly confused .Recently I saw  an ultrasound report from a renowned ultrasonologist mentioning occipitoposterior position of the baby at 38 weeks on routine scan and even telling the patient that it is an unfavourable position for normal delivery. First of all position of the baby before start of labour does not change the obstetrical management in any way. It is only the presentation cephalic or breech ( head at lower pole or not) which matters. Secondly why confuse the patient with a statement which does not alter management in any way? 90% of occipitoposterior positions will turn to the more favourable occipitoanterior position. The ultrasonologist in question felt that he was helping the patient and the obstetrician by remarking on an  additional foetal parameter .But in reality he or she implanted seeds of anxiety and fear of failure in the patient”s mind before she began her labour journey. Most of the time we as obstetricians don’t give feedback to the ultrasonologists thinking they will not understand .
By the way this patient had an uneventful vaginal delivery