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Re: condyloma in pregnancy From: Raymond Stephen (stephen.raymond@dhhs.tas.gov.au) Mon Mar 19 16:06:47 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: GIN11153@aol.com: "unbelievable!! Medicare Pays Doctors Owing Back Taxes" Previous message: Dean Huffman .: "A clinic is advertising fertility services for gay men." In reply to: Gordon Goldman: "Re: condyloma in pregnancy" Next in thread: Jefferson Delfino: "Re: condyloma in pregnancy" After much experience with condylomata both in and out of pregnancy my policy is to cauterise all condylomata that are in any way obstructing the vagina or are situated in a position on the perineum which would make a perineal repair after delivery difficult. Bleeding from friable tissues is a problem if this is not done. There is no reason in my experience to plan a C/S unless you see her for the first time after about 34 weeks. Doing the cautery within 6 weeks of EDD runs the risk that healing may not be complete when comes the time for delivery. There is no reason to be concerned about possible effects on the fetus as the electrophysiology of cautery means that the only effect is local at the electrode tip even when using monopolar instruments. I suggest, if you don't believe me, that you read up about electrocautery on any reputable site or in a textbook about operative laparoscopy. Steve ________________________________ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Gordon -- ________________________________ Goldman Sent: Monday, 19 March 2007 4:53 AM To: Multiple recipients of list OB-GYN-L Subject: Re: condyloma in pregnancy I agree, not worth taking any chance with vocal cord condylomata. However, have had the unfortunate experience of delivering vaginally through a 'forest of condylomata' and had horrendous bleeding complications from friable tissues. Would not advise that under any circumstance and would opt for C/S for both the baby and mother's safety. 1. Wait til near term to do anything. 2. If still present and only external, let pt decide for optional C/S vs min. risk of vocal cord problems (DOCUMENT, DOCUMENT, DOCUMENT). If vaginal lesions, recommend C/S for safety of both. 3. If still present near term and not extensive, consider using bipolar Kleppinger for electrocoagulation to minimize any effects on fetus. Gordon On Mar 18, 2007, at 11:57 AM, ENDODOK@aol.com wrote: Why take the risk of the baby developing vocal cord condyloma? Agree that spontaneous resolution could occur before term. The one patient I had whose child had cord condyloma ( she had delivered elsewhere) had suffered dramatic voice loss secondary to repeated CO2 laser Rx. I also recall seeing a CXR of a 12 year old who died from condyloma that filled his trachea and bronchi. With "section on demand" increasingly popular, elective C/S IMHO is a prudent consideration. JGB CONFIDENTIALITY NOTICE AND DISCLAIMER The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission. If the transmission contains advice, the advice is based on instructions in relation to, and is provided to the addressee in connection with, the matter mentioned above. Responsibility is not accepted for reliance upon it by any other person or for any other purpose. Next message: GIN11153@aol.com: "unbelievable!! Medicare Pays Doctors Owing Back Taxes" Previous message: Dean Huffman .: "A clinic is advertising fertility services for gay men." In reply to: Gordon Goldman: "Re: condyloma in pregnancy" Next in thread: Jefferson Delfino: "Re: condyloma in pregnancy"

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