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Re: VBACFrom: RModugno@aol.comSat Oct 28 14:55:53 2000
In a message dated 10/28/00 2:18:44 PM Eastern Daylight Time, midwife2be@lvcm.com writes:
<< How much do you think the time difference is between our ability
to get a woman to a hospital operatory (when we phone ahead) and our local
hospital ability to get a woman to an urgent c/s?
>> Alana, there are documented cases with VBAC in hospital, with the OR suite down the hall, where the uterus has ruptured, and the baby has been lost, and with varying degrees of maternal morbidity. I won't bore you with figures - but those that you quote, are from early VBAC trials. As vbac becomes more and more frequent, those rupture percentages may well change - and I have a suspicion they won't be in the downtrend! Now, the rates of rupture are about three to four times higher with the use of pitocin, so that type of intervention obviously occurs only in hospital settings and therefore increases the riskiness of the procedure! One question: have you actually witnessed a patient with a vbac and uterine rupture? Robert Modugno MD MBA FACOG Marietta, GA
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