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Re: OB: Complete Previa, AnteriorFrom: ainsron@msn.comThu Jun 1 09:25:21 2000
>1. When do you section the known previa who is not bleeding, but has >bled before requiring hospitalization? 37, 38, 39 weeks? Amnio if less than ____? weeks? I usually schedule at 38 wks, to avoid labor. Recently though I delivered one at 38 wks, with good dates, sonogram, etc. whose baby developed mild RDS and required transfer to a tertiary care center. Makes me wish I would have done an amnio. > >2. Do you make a transverse skin incision, if that is your norm? >Larger? I would normally make a transverse incision, no larger than usual, it can always be extended.
>3. If you think the placenta is underneath where your normal low transverse incision is going to go, do you go vertically? If they are multips versus primips, or having a tubal ligation, does that matter? If there is a well developed lower uterine segment, I would make a transverse uterine incision, unless I see extensive venous development making me concerned about an acreta. In that case I make a vertical uterine incision, and it wouldn't matter if multip or primip or TL.
-- Ronald E. Ainsworth, MD
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