Re: Three-peat section
From: Andrew Folley (agfolley@hotmail.com)
Mon Jan 22 13:15:52 2007
Hail Caeser! Et tu brute"
>From: "Shell" <birthfirst@msn.com>
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: Re: Three-peat section
>Date: Sun, 21 Jan 2007 16:42:38 -0600
>
>"My practice would be to do the Caesar at 10 days before the due date."
>
>Even when this woman has a history of dehiscence at 39 wks, showing
>evidence of poor healing and then became pregnant shortly after surgery?
>
>Surgery at 39 wks? Is that is? Any further evaluations? In places where
>the history of this patient is more common, catastrophic antenatal rupture
>is not uncommon. What in her history and situation improves her status?
>Is there absolutely any reason to believe that dehiscence wont occur at 20
>wks?
>
>Just curious.
>
>Shell
>
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> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod,
>------------------------------------------------------------------------------
>Darryl G Maj 48 MDOS/SGOBO
> Sent: Friday, 19 January 2007 8:04 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: Three-peat section
>
> Generally I wouldn't be worried much about a third c-section, but, I
>never thought I'd have the chance personally to do a third section on the
>same person in a three year tour either. I just found out that I will be
>doing this ladies third section in less than 3 years. At the time of her
>last section at 39 wks she had a window where I could see amniotic fluid
>without opening the uterus. I did a double layer closure with this one
>(not entirely sure if I did on the first one or not.I'd have to go back and
>look)
>
> Does anyone have any good data on prediction of risk of rupture by
>ultrasound? I have seen a few articles that have discussed measuring the
>lower uterine segment thickness but nothing that states 'if the thickness
>is X the risk of rupture is Y.' I'm hesitant to let this young lady go all
>the way to 39 wks and I'm thinking of just sectioning her at 38 wks without
>an amnio or sooner with an amnio.
>
> Any thoughts?
>
> Glen
>
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