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Re: 2am roundtable discussionsFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Sat Nov 17 05:12:58 2007
At Fri, 16 Nov 2007, DMECNM@aol.com wrote: > >It is 2 a.m., the board is full, no one is going to bed anytime soon. There >are still 5 laboring women in waiting room hoping for a bed ... soon. > >Discussion at the desk regarding what we all learned 10, 20, 30 years ago as >"standard practice". > >So, how many of you, regardless of circumstances, inspect for a cervical >laceration on EVERY and ALL vaginal deliveries? > >Denise, CNM >So Cal Only if there is more bleeding than normal, I have had to repair cervical lacerations on a half dozen occasions over the last few decades, most common occasion, primip mom O.P. long second stage and slow end of first stage delievers O.P. and then get called by midwife or family doc, they are usually easy to repair and have only had to pack the lower segment/cervix on two occassions to avoid hyst, have not had to do a hyst for cervical lacerations yet knock on wood. I get called for purple object protruding from vagina at least 3-4 times a year which is almost always the cervix has only been an inverted uterus on two occasions. Severe cerivical laceration will be visible on speculum exams for years latter(they don't all Bleed most probably go unrecognised), they are often reffered for abnormal mass/polyp on the cervix. Pushing on an anterior lip/rim in a primip O.P. is the classic set up for a severe cervical laceratiion.
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Take care, John
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