Re: procidentia and 3rd trimester
From: R. Daniel Braun (rd.braun@gmail.com)
Fri Sep 29 19:29:53 2006
AVOID Dhurrsen's incisions if at all possible. They bleed and tend to get
infected very easily.
Dan
On 9/29/06, Jay Kulkin <jkulkin@mindspring.com> wrote:
>
> I had a case of 3rd degree cervical prolapse at term in 1982! As I
> recall we managed her expectantly as any other pregnancy and did not
> induce. The risk is cervical edema, infection and failure to progress
> secondary to mechanical outlet obstruction due to severe edema. We did
> modified Duhrssens Incisions at delivery and she had an uneventful delivery
> otherwise. I remember being a Chief Resident at the time and made sure my
> attending was somewhere around all the time even though he wasn't sure what
> to do either. Risk of extending the Durhssens is present with the
> extensions going under the bladder or toward the ureters. Maybe today she
> would come to Elective Section.
>
> Since I don't think I've commented on an OB case on the list in years, I'm
> especially interested to hear how things go. Look up Duhrssens incisions
> and I think you'll finds plenty of literature.
>
> Best of luck.
>
> Jay
>
> ------------------------------
>
> ------------------------------
> *From:* ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] *On Behalf Of *Ger=
> ------------------------------
ald
> P.Rodriguez
> *Sent:* Friday, September 29, 2006 4:02 PM
> *To:* Multiple recipients of list OB-GYN-L
> *Subject:* Re: procidentia and 3rd trimester
>
> To my mind, "complete" procidentia means that the cervix *and* most if not
> all of the uterus is out the vaginal introitus. Clearly this is can only be
> a cervix prolapse in someone at 35 weeks as the major portion of the
> fundus has to be out of the pelvis and in the abdomen. Please tell us what
> exactly is hanging out.
>
> Gerald P. Rodríguez, M.D., FACOG
>
> Santa Fe
>
>> ----- Original Message -----
>
> *From:* Charlie Chambers <ricechaz@earthlink.net>
>
> *To:* Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>
> *Sent:* Friday, September 29, 2006 2:24 PM
>
> *Subject:* procidentia and 3rd trimester
>
> Our practice has a current patient with complete procidentia at 35 weeks.
> Discussions revolve around mode of delivery. I've done a lit search and not
> much for guidance. Anyone have any experience?
>
> ****************************************************************************
>
> Charlie Chambers
>
> Hood River, OR
>
> cchamber@alumni.rice.edu
>
> "Almost anything you do will seem insignificant but it is very important
>
> that you do it....You must be the change you wish to see in the world"
>
> -- Mahatma Ghandi.
>
> *******************************************************************************
>
>
--
R. Daniel Braun
"The way to health is an aromatic bath and scented massage everyday"..
Hippocrates
