Re: 2am roundtable discussions

From: Dr Eberhard Lisse (el@lisse.NA)
Mon Nov 19 03:02:32 2007

Allan,

With all due respect, before Semmelweis all our colleagues were enjoying their good results too...

Is there some evidence that a vaginal digital manipulation post C/S is safe?

And, while we are at it, is there evidence that we should express clots from the uterus at all?

el

on 11/19/07 6:49 AM AllanHo@aol.com said the following: > In a message dated 11/18/2007 5:28:23 PM Eastern Standard Time,
> stephen.raymond@dhhs.tas.gov.au writes:
>
> Agree with el - it is unnecessary to "open" the cervix - even in the
> non-pregnant it is open, and after a Caesar it will certainly open
> itself further with all those prostaglandins about. Getting clots out
> of the vagina has the advantage that you know whatever comes out in the
> recovery room is new bleeding, but it only requires some suprapubic
> pressure to empty the vagina on the operating table. Pushing things
> into the vagina from below is a good way to get infection into the upper
> genital tract. Don't do it!
>
> Steve
>
> All Cesarean sections are "contaminated procedures". The vagina and
> uterus is a continuous space. Suprapubic pressure on the operating
> table with patient's legs closed likely would result in fluid from the
> vagina being pushed up into the uterus as well as out of the vagina. I
> don't think you can say that your way is better than my way. I have
> enjoyed my good results and would like to continue to do so.
> Neverthelss, it is interesting to know what other people are doing out
> there.
>
> Respectly,
> Allan

--
Dr. Eberhard W. Lisse  \        / Obstetrician & Gynaecologist (Saar)
el@lisse.NA el108-ARIN / *     |   Telephone: +264 81 124 6733 (cell)
PO Box 8421             \     /   Please do NOT email to this address
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