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Re: OB: Prior infundibulationFrom: cherivh@xdcr.comThu Aug 5 09:23:09 2004
>-- Original Message -- >Date: Thu, 5 Aug 2004 07:38:15 -0500 >Reply-To: ob-gyn-l@obgyn.net >From: evsono@pipeline.com (art fougner, md) >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >Subject: Re: OB: Prior infundibulation > >All these vaginal incisions have the potential to induce more blood-loss >than a C-section. Setting aside the issue of how exactly this woman was >able to conceive, I feel el might be on point. Of course, my record in >dealing with this situation is spotless - i have NO experience >whatsoever. Garry, you would make a great Boards examiner ... > I have delivered one of these women and cared for another in pregnancy and postpartum. The first was a primip. I cut a small mediolateral episiotomy, but the anterior skin flap tore along the midline most of the way to the top. I asked how she wanted it repaired. She preferred to have it opened the rest of the way and left "more normal." I was assisted at this birth by a very experienced nurse who was a British-trained midwife with experience working in Saudi Arabia for 5 years as a midwife there. She had delivered dozens of these women. The second was a woman with 4 previous deliveries. The delivering physician cut a large mediolateral episiotomy with this 5th delivery. The woman was very sad and distressed afterwards, as all of the previous 4 had only involved the anterior incision and repair to the infibulated state and she reported those were less painful and healed better. She found the mediolateral episiotomy very painful and debilitating. Cheri Van Hoover, CNM, MS Faculty OB/GYN Group University of San Francisco, CA
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