Forwarded from Prenatal list, is a really interesting question:

>My question for the day is, does anybody know anything about postpartum
>management of moms with Turner's Syndrome?  I have a patient who is a
>Turner's Mosaic, pregnant via in vitro with a donor egg.  She had her
>puberty and menses managed with exogenous hormones, had to take
>progesterone to maintain early pregnancy.  Now she and I both have
>questions about what's going to happen post-partum.  I did a lit search,
>and found only 10 articles in the last thirty years, with none
>specifically addressing post-partum hormone management.  There was
>absolutely nothing on lactation in Turner's syndrome.  She would also
>like to maintain her uterus in a state that will allow her to have
>another child in the next year or two.  The endocrinologist that followed
>her in childhood has suggested to the family that early estrogen therapy
>will be important in allowing her to get pregnant again.
>
>So, what is going to happen postpartum?  Is she going to need any hormone
>therapy?  Will she be able to lactate?  Will she need exogenous hormones
>in order to lactate?  If so, will this treatment interfere with
>treatments to help her get pregnant again later?  Any ideas, anybody?
>
>I turfed this to the lactation consultant, and she is going to check it
>out on the lacation on-line discussion group.
>
>Also, no surprise, she is 34 weeks and pre-eclamptic, and we're looking
>at delivery in a week, so if somebody could point me in the direction of
>some information before then, it would be much appreciated.
>
>Also, writing this note about a specific patient has made me wonder what
>the on-line etiquette about maintaining confidentiality is.  I have tried
>to avoid using identifying information here.  Any information on this issue
>would also be appreciated.
>
>Sincerely,
>
>Kristen D. Priddy, RNC, MSN

Arly Helm               [log in to unmask]
MS, Nutrition & Food Science, CLE, IBCLC