Re: split infinitives again
From: Dr. Bülent Potur (bpotur@yahoo.com)
Thu Jul 26 07:35:16 2007
Sir,
I have hot been there. But I can tell you anyhow that I wouldn't do a
hysterectomy on a 6 weeks postpartum lactating woman with a completely
involutioned healthy uterus.
Regards,
Bulent Potur
At Wed, 25 Jul 2007, R. Daniel Braun wrote:
>
>All it takes is to have done a hysterectomy on someone 6 weeks postpartum,
>then you know how hypervascular the uterus is
>
>On 7/25/07, Dr. Bülent Potur <bpotur@yahoo.com> wrote:
>>
>> Well Dan,
>> I had just tried to emphasize the hypoestrogenic state
>> of lactating women and the case's similarity in the
>> insertion to a lactating woman in resembling the
>> vulnerability of the uteri of lactating women in the
>> quoted literature.
>> So I do not have the color doppler data of this case
>> or the 6 week post partum uteri in general.
>> Thank you.
>>
>> Bulent Potur
>>
>> --- "R. Daniel Braun" <rd.braun@gmail.com> wrote:
>>
>> > I would disagree with the "avascular" part of your
>> > statement. At 6 weeks
>> > postpartum the uterus is still quite HYPERVASCULAR.
>> >
>> > Dan
>> >
>> > On 7/25/07, Dr. Bülent Potur <bpotur@yahoo.com >
>> > wrote:
>> > >
>> > > Below is a publication when I had found for a case
>> > report of mine. An
>> > > IUD diagnosed in the pouch of Douglas with vaginal
>> > ultrasound Dirim
>> > > Sep-Oct 2002 31-34) The case also was consistent
>> > with the majority of
>> > > the review below. The IUD had been inserted at
>> > 6th week post partum to
>> > > a lactating women. When the uterus was so thin
>> > and avascular and prone
>> > > to perforation The patient had been referred when
>> > the strings of the IUD
>> > > was not seen at check 2.5 months later insertion.
>> > > Bulent Potur MD Obgyn
>> > > Kirikkale TURKEY
>> > >
>> > > 1: Contraception. 1998 Apr;57(4):251-5.Click here
>> > to read Links
>> > > Perforations with intrauterine devices. Report
>> > from a Swedish survey.
>> > > Andersson K, Ryde-Blomqvist E, Lindell K,
>> > Odlind V, Milsom I.
>> > > Department of Obstetrics and Gynecology,
>> > Sahlgrenska University
>> > > Hospital, Göteborg, Sweden.
>> > > This survey comprised 50 consecutive perforations
>> > occurring with
>> > > intrauterine devices (IUD) reported to the
>> > National Patient Insurance
>> > > Scheme Register during 1990 to 1993. All 50 women
>> > were parous and > 20
>> > > years of age at the time of IUD insertion.
>> > Forty-two (84%) of the IUD
>> > > were inserted by a midwife and eight by a
>> > gynecologist. A total of 45
>> > > women (90%) had their IUD inserted < 1 year after
>> > a full-term pregnancy
>> > 12 weeks after
>> > > delivery. Of the 50 women, 27 (54%) reported that
>> > they were
>> > > breastfeeding at the time of IUD insertion. No
>> > particular IUD was
>> > > overrepresented in relation to its share on the
>> > market. In 31 cases
>> > > (62%), severe pain at insertion and during the
>> > first 24 h was recorded.
>> > > In 14 women (28%), the perforation was diagnosed
>> > early (i.e., within 1
>> > > month of insertion) and in 36 women (72%), the
>> > perforation was diagnosed
>> > > > 1 month after insertion. Lower abdominal pain
>> > was the most frequent
>> > > symptom at early diagnosis but in two cases, the
>> > main symptom was heavy
>> > > bleeding. Among the 36 women in whom the
>> > perforation was discovered
>> > > more than 1 month after insertion, the diagnosis
>> > was made when an
>> > > unexpected pregnancy occurred in 20 women (56%).
>> > In 15 cases, the IUD
>> > > strings were not visible during pelvic examination
>> > at a routine
>> > > check-up, which led to efforts to locate the IUD.
>> > Thirty-two women
>> > > (64%) underwent laparotomy for removal. We
>> > conclude that lactating
>> > > women seem to be a risk group for perforation and
>> > that a national
>> > > register of IUD perforations could provide a
>> > better means of quality
>> > > control.
>> > > PMID: 9649917 [PubMed - indexed for MEDLINE]
>> > >
>> > > At Tue, 24 Jul 2007, GIN11153@aol.com wrote:
>> > > >
>> > > >Friend asked me about perforation rate. I don't
>> > have an answer but
>> > > thought
>> > > >that it is an accepted complication that is
>> > discussed in an informed
>> > > consent.
>> > > >Your thoughts, please!
>> > > >
>> > > >Gail Neuman RNC CPHW
>> > > >student midwife and student nurse practitioner
>> > > >certified high risk OB
>> > > >Perinatal Nurse Associates
>> > > >801 N. Tustin Ave., Suite 305
>> > > >Santa Ana, CA 92705
>> > > >(714) 314-7070
>> > > >(714) 838-1479 fax
>> > > >
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