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Re: cervical scarring From: Joanne Bulley (islesannie@yahoo.com) Tue Apr 3 22:38:30 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Akhan Suleyman: "Re: ultrasound diagnosis of abruption" Previous message: Charlie Chambers: "Re: Pre-eclampsia in the news -- REPLY" In reply to: maggiela@rochester.rr.com: "cervical scarring" Next in thread: Marco A. Pelosi, III, MD: "Re: cervical scarring" I have had a couple of these usually after the patient has had several cryos/cones etc - most eventually "gave way" to digital "tearing" . I have had some I put in stirrups and used (extra long) scissors - or scalpel - do an X or + and then it gives way. One I went to the OR and got a spinal - the others weren't really that painful. I guess I had 6 or 7 of these between 1985 & 1998. One patient that I can recall quite clearly - went to the OR as above, finally delivered vaginally, postpartum the cervix looked quite normal and second labor was completely normal. Joanne At Tue, 3 Apr 2001, maggiela@rochester.rr.com wrote: > >Had a clinic patient last week who presented to L &D with ROM and this >history: G2P1, previous C-sec for FTP. Exam:fingertip/100%/-2. Cervix >scarred from Letz procedure after first birth. Could not break up scar >with digital exam. My plan was to get pt and epidural and try again >once she was comfortable. Pt ended up with a repeat c-section as the >in-house attending did not seem to feel this was a valid management >option. Any suggestions on how to manage these patients-how to break up >that scar or how to know when to not try? What anesthesia would you >suggest- none, epidural, pudendal, paracervical? > >Interestingly enough, this patient had been on Depo for 2 years and had >switched to OCPs in August 00. She continued on OCPs until 2/01 when >she thought she felt something funny! She was about 32 weeks pregnant >and had taken OCPs faithfully every day throughout her pregnancy!! > >-- >Maggie, CNM > -- Joanne Bulley, MD, FACOG Keene, NH, USA Next message: Akhan Suleyman: "Re: ultrasound diagnosis of abruption" Previous message: Charlie Chambers: "Re: Pre-eclampsia in the news -- REPLY" In reply to: maggiela@rochester.rr.com: "cervical scarring" Next in thread: Marco A. Pelosi, III, MD: "Re: cervical scarring"

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