Re: cervical scarring

From: Paul Prior MD (pprior@clover.net)
Thu Apr 5 20:20:21 2001


On Tue, 3 Apr 2001 20:39:42 -0500, 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

I have had several patients with prior LEEP/LLETZ who at term became paper thin cervix but would not dilate beyond a fingertip. Most can be broken up with digital exam but the few that didn't I placed into the stirrups and with long dressing forceps to stretch and break the scar tissue and all of them delivered vaginally with no problems, usually quite quickly. I have not seen this published anywhere, but was taught this (as many good things) by my chief resident and it has served me well.

I think you were on the right track.

--
Paul Prior MD
Coshocton, OH
Solo Practice
OB/GYN, FACOG




use when must restrict search to only the ob-gyn-l forum...
Enter search keywords:
Returns per screen: Require all keywords:

Return to  OB-GYN-L Mail a New Message to the Forum: ob-gyn-l@obgyn.net
Forum Administrator: geffrey.klein@obgyn.net
Report Technical Problems: webmaster@obgyn.net
Last Updated: Wed Dec 2 04:50:05 2009

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.