Re: One layer uterine closure
From: Cesar Molina (cemolar777@gmail.com)
Sat Sep 9 18:22:33 2006
Efraín, discúlpeme mi mal dominio del inglés, a qué se refieren cuando
hablan de "locked" y "unlocked" .?????
2006/9/8, Efrain Ramirez <eramirezt@coqui.net>:
>
> Same here Ron - I am reaching 30 years :) un abrazo,
>
> Ef
>
> >>At Fri, 8 Sep 2006, ainsron wrote:
> >
> >I've locked the first layer for 25+ years and unlocked the second layer
> with
> >an imbricating stitch - so I guess I'm a hybrid. I also close the
> bladder
> >flap most of the time. Looking back when I do repeats, I have not seen a
> >significant number of adhesions or complications, compared to repeats I
> do
> >on other patients who move into my practice. Like you Efrain, I'll
> continue
> >doing it my way unless I see evidence that it is not working or I am
> placing
> >my patients at risk.
> >
> >Ronald E. Ainsworth, MD, FACOG
> >
> >-----Original Message-----
> >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Efrain
> >Ramirez
> >Sent: Friday, September 08, 2006 4:38 AM
> >To: Multiple recipients of list OB-GYN-L
> >Subject: Re: One layer uterine closure
> >
> >I use unlocked 2 layers.. until the evidence shows something
> >better....thanks..
> >
> >Ef
> >
> >>At Thu, 7 Sep 2006, R. Daniel Braun wrote:
> >>
> >>If you read the whole article, you will find that the single layer
> closures
> >>were all LOCKED sutures. This would make a big diference. The study
> needs
> >>to be done comparing with UNLOCKED single layer.
> >>
> >>Dan
> >>
> >>On 9/7/06, Efrain Ramirez <eramirezt@coqui.net> wrote:
> >>>
> >>> At Thu, 7 Sep 2006, R. Daniel Braun wrote:
> >>> >
> >>> >OOOOOOOOHHHH!!!!!!!!!!!
> >>> >Data???
> >>> >
> >>> >Dan
> >>> The impact of a single-layer or double-layer closure on uterine
> rupture.
> >>> Bujold E, Bujold C, Hamilton EF, Harel F, Gauthier RJ
> >>>
> >>> Am J Obstet Gynecol (2002 Jun) 186(6):1326-30 ISSN: 0002-9378
> >>>
> >>> Obstetric Surgical Procedures
> >>> Uterine Rupture
> >>> Cohort Studies
> >>> Comparative Study
> >>> Female
> >>> Human
> >>> Odds Ratio
> >>> Pregnancy
> >>> Recurrence
> >>> Trial of Labor
> >>>
> >>> Abstract
> >>>
> >>> OBJECTIVE: Our purpose was to measure the impact of a single-layer or
> >>> double-layer closure on uterine rupture at subsequent delivery.
> >>>
> >>> STUDY DESIGN: This is an observational cohort study of all women
> >>> undergoing a trial of labor from 1988 to 2000 in a tertiary care
> center,
> >>> after a single low transverse cesarean delivery. Factors most highly
> >>> associated with uterine rupture were identified by using univariate
> >>> regression analysis. Multivariate logistic regression analysis was
> used
> >>> to adjust for selected confounding variables.
> >>> Top of Abstract
> >>> RESULTS: Of the 2142 women who met the study criteria, 1980 (92.4%)
> had
> >>> maternal records and original operative reports reviewed. After
> >>> adjustments were made for confounding variables, the odds ratio for
> >>> uterine rupture in women with a single-layer closure was 3.95 (95% CI,
> >>> 1.35- 11.49).
> >>>
> >>> CONCLUSION: A single-layer closure of the previous lower segment
> >>> incision was the most influential factor and was associated with a
> >>> 4-fold increase in the risk of uterine rupture compared with a
> >>> double-layer closure.
> >>>
> >>> --
> >>> R. Daniel Braun
> >>>
> >>> "The way to health is an aromatic bath and scented massage
> >>> everyday".
> >>> Hippocrates
> >
> >--
> >" The greatest obstacle to knowledge is not ignorance,
> >it is the illusion of knowledge." Daniel J. Boorstin - Historian
> >
>
> --
> " The greatest obstacle to knowledge is not ignorance,
> it is the illusion of knowledge." Daniel J. Boorstin - Historian
>
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