Re: Adhesions at c/s.

From: David A. Nagey, MD, PhD, PE, FACOG (dnagey@welchlink.welch.jhu.edu)
Thu Sep 19 19:37:37 1996


At her second >section she had such thick,dense, vascular, adhesions of anterior wall to
>fundus that we had difficulty getting to the lower uterine segment. The
>patient lost a fair amount of blood during the case but did well

>I didn't have an answer but wondered out loud if pelviscopy with lysis of
>adhesions and possibly interceed would lessen the adhesions and improve
>her outcome.

If it ain't busted, don't fix it. I would consider pelviscopy (remunerative laparoscopy) if she had trouble conceiving, but would not intervene in an anticipatory manner - you might add infertility to her problem list

David

--
David A. Nagey, M.D., Ph.D., FACOG
Division of Maternal-Fetal Medicine, The Johns Hopkins Hospital
(888) 800-8150, FAX (410) 614-8305
dnagey@welchlink.welch.jhu.edu




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