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Re: large uterine fibroids and natural laborFrom: ainsron (ainsron@sbcglobal.net)Thu Jun 3 18:00:28 2004
If she can't be convinced that it is not necessary, I would do it also. Patient autonomy is important. She needs to realize that doing a C/S and TL does not guarantee her that she will not need a hysterectomy next year when they begin bleeding or enlarging. If you want to offer her sterilization plus avoiding another surgery, bring up the subject of Cesarean hysterectomy. We did a fair number in residency for similar situations. We also did a fair number of vaginal hysterectomies simply for sterilization, but that is another story. In practiced hands and controlled circumstances, a cesarean hysterectomy would be a safe option. Most of the C/hysts we do are in emergency circumstances, and other than blood loss and occasional transfusions, turn out well also. The blood loss is usually due to the pathology, not the procedure. Ronald E. Ainsworth -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of ND84MD@aol.com Sent: Thursday, June 03, 2004 3:03 PM To: Multiple recipients of list OB-GYN-L Subject: Re: large uterine fibroids and natural labor In a message dated 6/3/04 4:40:10 PM, Theresa333@aol.com writes: I have a 42 year old G3 P2 asking for a primary c section if she asks for it, do it.
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