Re: C/S complications

From: Elrod Darryl G MAJ 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL)
Tue Nov 29 04:19:02 2005


They do get TEDS, but I'm not sure what clexane is. They get a single dose of antibiotics at cord clamp.

As far as risks go with relation to vaginal delivery I have to say I probably spend more time talking about risks with c/s than with vaginal deliveries. I saw a pt my partner was treating for an laceration (partial 3rd degree) that fell apart after delivery requiring dressing changes, pain in general, pain with bowel movements (which continues to get into the wound) etc etc. I'm certain that unless pressed I don't tell women that there is a risk of infection with vaginal delivery. Of course we know there is always a risk, but I don't spell it out like with c/s. I don't tell them that they could not tear, tear a little, tear a lot, have that tear break down and get necrotic edges that need debridement, that they could develop a rectovaginal fistula after a delivery, that they may or may not be continent after a labor depending on any number of factors, that their labia may be so swollen they can't sit down for a week and on an on.

Glen

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From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of

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GA12L@aol.com
Sent: Tuesday, November 29, 2005 11:05 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: C/S complications

In a message dated 29/11/2005 10:42:04 GMT Standard Time, Darryl.elrod@LAKENHEATH.AF.MIL writes:

Risk of additional surgeries. For example, hysterectomy, bladder repair, etc

I'll give you these

Gee thanks. But I was talking about the risks in comparison to a vaginal birth. These are risks that are absent or negligable with a vaginal birth.

<<but I can't remember the last c/s we did under general.>>

A crash section (the baby has to be out within 30 mins of the decison being made) will sometimes be done under a GA if the woman has not had an epidural. All electives are done under spinal unless a woman insists on a GA. Our epiduarl rate is much lower. There was research published a few weeks back that linked epidurals with operative deliveries so they've gone down even more.

Do your women have TEDS and clexane prescribed after a section?

Gail





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