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Re: Delivery with obstructing fibroid From: David Priver, MD (dpriver@aol.com) Fri Jul 25 21:09:38 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: Delivery with obstructing fibroid" Previous message: DoctorJoe@aol.com: "Re: GEN: Wrongful Life Metastasizes" In reply to: Braun, R. Daniel: "Re: Delivery with obstructing fibroid" Next in thread: Efrain Ramirez: "Re: Delivery with obstructing fibroid" Dan, I must disagree with your suggestion to do a classical section in this situation. The myoma could well be posterior, in which case the section need not be classical at all. Remember that a classical section renders a woman an obstetical cripple, subject to catastrophic uterine rupture in a future pregnancy. I continue to see no cogent argument for not letting this patient enter labor. Odds are excellent that she will deliver. At Fri, 25 Jul 2003, Braun, R. Daniel wrote: > >Classical section. Stay FAR FAR AWAY from the fibroid. Leave it alone >and it most likely won't bleed. > >Dan > >-----Original Message----- >From: Shannon Burke [mailto:shannon.burke@dhha.org] >Sent: Thursday, July 24, 2003 6:04 PM >To: Multiple recipients of list OB-GYN-L >Subject: Delivery with obstructing fibroid > >We have a primigravid woman at 36 weeks with a 9x11x13 cm fibroid in the >lower uterine segment that fills the pelvis. The infant is above the >fibroid, is growing well and the placenta is fundal. We are planning a >cesarean delivery in IR at 37.4 weeks with embolization if needed for PP >hemorrhage. One of our faculty suggested that instead we attempt a >vaginal delivery. He had a similar case in which a fibroid as large as >this "pulled up" during labor and the patient delivered without any >complications. The difficulty of course, is that if she has a >hemorrhage after a vaginal delivery (if she could deliver) we may or may >not be able to make it to IR and she might have a hysterectomy instead. >Has anyone else had a similar situation? Do you have suggestions for how >the differentiate the case that will deliver vaginally? Any other >thoughts? Next message: Efrain Ramirez: "Re: Delivery with obstructing fibroid" Previous message: DoctorJoe@aol.com: "Re: GEN: Wrongful Life Metastasizes" In reply to: Braun, R. Daniel: "Re: Delivery with obstructing fibroid" Next in thread: Efrain Ramirez: "Re: Delivery with obstructing fibroid"

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