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Re: Inverted uterus From: Bernard Cristalli (bcrist@club-internet.fr) Wed Jul 21 13:50:09 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Lynn D. Montgomery, M.D.: "Re: Inverted uterus" Previous message: Richard Chudacoff, MD: "Re: LDR v. LDRP" In reply to: RModugno@aol.com: "Inverted uterus" Next in thread: Lynn D. Montgomery, M.D.: "Re: Inverted uterus" In irreductible cases, prior to a hysterectomy, one can perform a hysterotomy. You cut the stricture and the depression vertically, and the inversion is reduced. You get a scarred uterus, but you still have one. -- Bernard Cristalli MD AMACOG AIHP - ACCA Paris France http://www.CliniquedelEssonne.fr http://www.obgyn.net/corresp/cristalli.htm http://www.gyneweb.fr '64 Mk2 3.8 > De : RModugno@aol.com > > Helped a colleague with an interesting case this last weekend - patient with > an inverted uterus. Primigravida, delivered by CNM - presented with > post-partum hemorrhage - inverted uterus found. Despite general anesthesia > and attempts at cervical relaxation with IV nitroglycerin - manual reposition > failed. > > At laparotomy she had a classic uterine invesion. A modified Huntington's > technique was used to correct the inversion: > figure of 8 sutures were placed in the anterior and posterior uterine walls at > the edge of the "crater", and kelly clamps were applied to the round > ligaments. Upward and outward traction was applied to the kelly clamps and to > hemostats attached to the figure of 8 sutures. As the uterus began to "right" > itself, further figure of 8's were placed on the anterior and posterior eges > of the crater until the uterus was completely back in position. > > It's amazing how much less stressful it is when it's not your patient! > > Even more amazing:Many of the OB's when told about this case said:"You mean > you didn't have to do a hyst?" Seems like we need to do some CME on the > management of this frightening,unusual, potentially fatal condition! > > Robert Modugno MD MBA FACOG > Marietta, GA > http://www.novaobgyn.yourmd.com > Next message: Lynn D. Montgomery, M.D.: "Re: Inverted uterus" Previous message: Richard Chudacoff, MD: "Re: LDR v. LDRP" In reply to: RModugno@aol.com: "Inverted uterus" Next in thread: Lynn D. Montgomery, M.D.: "Re: Inverted uterus"

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