-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Post Partum BTL From: D. Ashley Hill (dahmd@cfl.rr.com) Tue Feb 27 20:51:32 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: Ob:  Advanced dilatation/footling" Previous message: Garry E. Siegel, M.D.: "Ob: Advanced dilatation/footling" Next in thread: Henry Gregor: "My partners think I'm a woos (?sp?)" Reply: Henry Gregor: "My partners think I'm a woos (?sp?)" In residency I was called to help with a 500# patient on the table (actually, 2 tables) for a postpartum BTL. Despite a lot of effort we could not get deep enough with the retractors and a large umbilical incision to find the tubes. Finally I took a sterile scalp pH "megaphone," lubed it up, and inserted it into the umbilical incision. I used 0-plain endoloops and laparoscopic instruments through the scalp pH device to tie the tubes sucessfully. I thought about writing it up but I felt like it was a "cowboy" move, although given the circumstances it was all I could think of. Now I would counsel for an IUD or interval Essure, or even a vaginal BTL, rather than try to find the tubes in a patient like you described. Ashley At Tue, 27 Feb 2007, Richard Kaplan wrote: > >About 6 months ago I had to abandon a post partum BTL on an obese patient >who was close to 36 hours post delivery because her fundus had involuted to >the point where I could not palpate it or find the tubes through my >subumbilical minilap incision. This morning I cancelled a BTL on another >obese patient 24 hours post partum when her fundus palpated well below the >umbilicus (14-16 wks.) and I was afraid that I would have the same problem. >She was happy to schedule a laparscopic procedure in 5 weeks. My partners >think I'm a woos. Have any of you had similar experiences? > >-- >Richard Kaplan > -- D. Ashley Hill, MD Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Medical Director, Loch Haven Ob/Gyn Group Division Director, Dept. of Ob/Gyn, Florida Hospital Orlando Orlando, Florida Next message: DoctorJoe@aol.com: "Re: Ob:  Advanced dilatation/footling" Previous message: Garry E. Siegel, M.D.: "Ob: Advanced dilatation/footling" Next in thread: Henry Gregor: "My partners think I'm a woos (?sp?)" Reply: Henry Gregor: "My partners think I'm a woos (?sp?)"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Jul 2 04:46:00 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.