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Re: Delivery with obstructing fibroid From: Steve & Eryl Raymond (eryl@intekom.co.za) Sat Jul 26 12:59:46 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Marilyn Ringstaff: "Re: GEN: Wrongful Life Metastasizes" Previous message: Braun, R. Daniel: "Re: Delivery with obstructing fibroid" Maybe in reply to: Shannon Burke: "Delivery with obstructing fibroid" Next in thread: Efrain Ramirez: "Re: Delivery with obstructing fibroid" Reply: Efrain Ramirez: "Re: Delivery with obstructing fibroid" Where are the cojones? Why not try and see if labour progresses and descent occurs. If not then cut as per usual. A classical section is overkill, likely to bleed just as much as the fibroid is likely to bleed, but yes, don't cut the fibroid. Why an elective section at 37+? I was always taught 38+. Defensive medicine is bad medicine. Steve 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] >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? > -- S.H. Raymond FRCOG Principal Specialist Department of Obstetrics & Gynaecology Empangeni Hospital Private Bag X20005 Empangeni SOUTH AFRICA 3880 Phone: (+27)-35-9028560 Fax: (+27)-35-7922596 Next message: Marilyn Ringstaff: "Re: GEN: Wrongful Life Metastasizes" Previous message: Braun, R. Daniel: "Re: Delivery with obstructing fibroid" Maybe in reply to: Shannon Burke: "Delivery with obstructing fibroid" Next in thread: Efrain Ramirez: "Re: Delivery with obstructing fibroid" Reply: Efrain Ramirez: "Re: Delivery with obstructing fibroid"

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