..... needs to have Colmes ditched for two reasons:

- stuff from the past two days.

- Hannity needs an intellectual challenge to sharpen his views.

People get tired of me hitting him on this at my place, but anyone in Hannity's position who not only couldn't see through Mitt Romney, but had him as a virtual co-host on his radio show for several months so he could promote Romney's transparent attempt to buy the vice-presidency, is losing touch with sensible conservatives, and sensible conservatism.

I nominate Kirsten Powers. Doesn't hurt that she's easy on the eyes either.

Motherbelt:

You are correct in that a physician not involved in the care of the patient and most likely completely ignorant of the medical history and specifics of the event has little but generalities to offer.  I don't know if Dr. Gregg shaped her answers to give fellow Democrats a talking point (something for which she should be reported to the board for if true) or if the reporter massaged the doctor's responses to give a narrow definition, but it appears there was a great deal of relavent data left out.

I have no idea of the specifics of Gov. Palin's medical history or prenatal history so I'll have to speak in general terms.

As you said, there is a difference between "leaking", a trickle of amniotic fluid, and "breaking" which I assume might be viewed as a sudden gush of copious amounts of amniotic fluid.  While the "leak" may turn into a "gush" unpredictably, the important medical distinction initially is that if there is very little amniotic fluid left to cushion the fetus then umbilical cord compression may occur, with potentially resultant dangerous decrease in blood flow to the fetus and potential for fetal demise (About 1% incidence of death for all causes including cord compression). 

Obviously a "leak" is not as emergent a risk to the fetus as a "gush".  Still, because one cannot tell if the fluid is amniotic fluid of urine, prudent standard of care is to have the patient come to the hospital ASAP to determine the etiology of the fluid and the well being of the fetus and the mother.

As to "leaking" amniotic fluid, termed Rupture Of Membranes (ROM), it is important to know whether there is concomittent labor (rhthymic contractions) and if the pregnancy is before or after 37 weeks, since these factors affect medical decision making.

For the sake of argument, let's assume there was only "leaking", there are no contractions, the pregnancy was 37 weeks or longer, the baby is behaving "reassuringly" (moving appropriately), and mother is otherwise healthy, then concerns for Gov. Palin and the baby getting an infection are low within the first 24 hours (less than 10%).  In fact, given the scenario above, most physicians will allow a trial of expectent management, ie allow labor to proceed naturally, since 90% of women will begin labor spontaneously within 24 hours after ROM.  Labor will be induced (using oxytocin) if there are no contractions or the contraction are inneffective, that point in time being the choice of the physician (12-24 hour mark oftentimes).  All of this is predicated on both mother and fetus otherwise healthy and without problems.

Additionally, pregnancies complicated by Premature Rupture Of Membranes (PROM - leak of amniotic fluid without labor contractions) have been studied where expectent management was utilized for up to 4 days, with real but small risk of infection occuring.  Also, It is possible that the leak will seal or the leak is small enough that the pregnancy is allowed to continue for a week or two if further fetal development is desirable and both mother and fetus are well.  Bottomline, not every leak requires emergent delivery.

Central to the question of infection and PROM is the use of antibiotics.  In the scenario of a PROM at 37 weeks or greater pregnancy and with fetus and mother both doing well in a trial of expectent management of labor and delivery, antibiotics are NOT manditorily required as per studies. 

Of course there are always exceptions on the use of antibiotics, such as Prolonged Rupture Of Membranes (>24hrs), Preterm Premature Rupture Of Membranes, signs/symptoms of infection, or unknown or positive history of Group B Streptococcus culture.

And the above management scenario is very different if the pregnancy is less than 37 weeks gestation (Preterm Premature Rupture Of Membranes), but that situation was not been reported by the media.

In general, Gov. Palin made a decision in concert with her physician that was not optimal but was of low risk (a "leak" which stopped? and no labor).  I would prefer my patient be seen ASAP if there is a leak, and, I would not want them flying commercially since there would be little medical care available if things took a bad turn.  Not knowing more of the facts, I cannot make any conclusion beyond generalities.  I would assume that her physician presented the risks and Palin made an informed decision, one that appears to not have compromised the health of the baby or the mother.

Lastly, Gov. Palin is one tough cookie.  She is the first in a long time of pioneer-type woman to potentially inhabit the White House.  If she were a Democrat, the Dems would be shouting praise from their moonbat rafters as to the grit Palin displays.  Shame on them for disgracing themselves with repugnant lies and distortions.

RRAM Tough!