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Re: Delivery with obstructing fibroid From: Efrain Ramirez (eramirezt@coqui.net) Sat Jul 26 18:06:40 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Delivery with obstructing fibroid" Previous message: Braun, R. Daniel: "Re: GEN: Wrongful Life Metastasizes" In reply to: Steve & Eryl Raymond: "Re: Delivery with obstructing fibroid" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Delivery with obstructing fibroid" Agree with you - but it's not about cojones - a vaginal delivery would be much, much better - and why a vertical incision if not needed?? I had a patient that we had to make a vertical *skin* incision *above* the umbilicus - no other way to reach the baby!! - AND the placenta was anterior and to the right -- it was a lot less messy than we've expected... >At Sat, 26 Jul 2003, Steve & Eryl Raymond wrote: > >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 > -- "The opposite of a correct statement is a false statement. But the opposite of a profound truth may well be another profound truth." Niels Bohr (1885 - 1962) Next message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Delivery with obstructing fibroid" Previous message: Braun, R. Daniel: "Re: GEN: Wrongful Life Metastasizes" In reply to: Steve & Eryl Raymond: "Re: Delivery with obstructing fibroid" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Delivery with obstructing fibroid"

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