OB-GYN-L Messages for November, 2007: Re: 2am roundtable discussions

Re: 2am roundtable discussions

From: FRANCES WREN

fwren@shaw.ca

Sat Nov 17 10:29:25 2007

with a normal non-instrumental vaginal delivery..I never inspect for cervical lacerations...if there is not much bleeding and there have been no instruments the likelihood of a cervical tear worth bothering about in my opinion is NIL so leave well alone. frances wren

>----- Original Message -----
From: johnprov@sympatico.ca (Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.) Date: Saturday, November 17, 2007 5:28 am Subject: Re: 2am roundtable discussions To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>

> At Fri, 16 Nov 2007, DMECNM@aol.com wrote:
> >
> >It is 2 a.m., the board is full, no one is going to bed anytime
> soon. There
> >are still 5 laboring women in waiting room hoping for a bed
> ... soon.
> >
> >Discussion at the desk regarding what we all learned 10, 20, 30
> years ago as
> >"standard practice".
> >
> >So, how many of you, regardless of circumstances, inspect for
> a cervical
> >laceration on EVERY and ALL vaginal deliveries?
> >
> >Denise, CNM
> >So Cal
>
> Int J Gynaecol Obstet. 1991 Feb;34(2):133-7.Links
> Postpartum colposcopy of the cervix: injury and healing.Fahmy K,
> el-Gazar A, Sammour M, Nosair M, Salem A.
> Department of Obstetrics and Gynaecology, Benha, Faculty of Medicine,
> Egypt.
>
> Colposcopic examination was done in 189 successive parturients within
> 6-48 h of delivery for evidence of type, site, and extent of cervical
> trauma and its relation to various obstetric factors.
> There was trauma
> in 66% of cases, as erosion in 79%, as laceration in 56%, as
> bruising in
> 30%, and as yellow areas in 17%. In about two-thirds of
> cases, the
> diameter of cervical erosion, or the length of laceration did
> not exceed
> 5 mm and 81% of lacerations were of first degree. Cervical
> injury was
> significantly more frequent in primiparae, in the anterior
> cervical lip,
> in occipito-posterior positions, and with premature rupture of
> membranes. In 117 parturients with cervical injury another
> colposcopicexamination was done 6-8 weeks postpartum. In
> 8% there was residual
> cervical damage.
>
> PMID: 1671367 [PubMed - indexed for MEDLINE]
>
> --
> Take care, John
>

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<DIV>with a normal non-instrumental vaginal delivery..I never inspect for cervical lacerations...if there is not much bleeding and there have been no instruments the likelihood of a cervical tear worth bothering about in my opinion is NIL</DIV> <DIV>so leave well alone.</DIV> <DIV>frances wren</DIV>

><DIV>  ----- Original Message ----- From: johnprov@sympatico.ca (Dr. John Provatopoulos  B.Sc. M.D.C.M. F.R.S.C.) Date: Saturday, November 17, 2007 5:28 am Subject: Re: 2am roundtable discussions To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> > At Fri, 16 Nov 2007, DMECNM@aol.com wrote: > > > >It is 2 a.m., the board is full, no one is going to bed anytime > soon.   There > >are still 5 laboring women in waiting room hoping for a bed > ...  soon. > > > >Discussion at the desk regarding what we all learned 10, 20, 30 > years ago  as > >"standard practice". > > > >So, how many of you, regardless of circumstances, inspect for > a  cervical > >laceration on EVERY and ALL vaginal deliveries? > > > >Denise, CNM > >So Cal > > Int J Gynaecol Obstet. 1991 Feb;34(2):133-7.Links > Postpartum colposcopy o
f the cervix: injury and healing.Fahmy K, > el-Gazar A, Sammour M, Nosair M, Salem A. > Department of Obstetrics and Gynaecology, Benha, Faculty of Medicine, > Egypt. > > Colposcopic examination was done in 189 successive parturients within > 6-48 h of delivery for evidence of type, site, and extent of cervical > trauma and its relation to various obstetric factors.  > There was trauma > in 66% of cases, as erosion in 79%, as laceration in 56%, as > bruising in > 30%, and as yellow areas in 17%.  In about two-thirds of > cases, the > diameter of cervical erosion, or the length of laceration did > not exceed > 5 mm and 81% of lacerations were of first degree.  Cervical > injury was > significantly more frequent in primiparae, in the anterior > cervical lip, > in occipito-posterior positions, and with premature rupture of > membranes.  In 117 parturients with cervical injury another > colposcopicexamination was done 6-8 weeks postpartum.  In > 8% there was residual > cervical damage. > > PMID: 1671367 [PubMed - indexed for MEDLINE] > > -- >                                  Take care, John > </DIV>

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