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Re: 2am roundtable discussions From: Raymond Stephen (stephen.raymond@dhhs.tas.gov.au) Sun Nov 18 15:23:56 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Gen: Fiber" Previous message: aditi desai: "Re: 2am roundtable discussions" In reply to: Efrain Ramirez: "Re: 2am roundtable discussions" Next in thread: ainsron: "Re: 2am roundtable discussions" Agree with el - it is unnecessary to "open" the cervix - even in the non-pregnant it is open, and after a Caesar it will certainly open itself further with all those prostaglandins about. Getting clots out of the vagina has the advantage that you know whatever comes out in the recovery room is new bleeding, but it only requires some suprapubic pressure to empty the vagina on the operating table. Pushing things into the vagina from below is a good way to get infection into the upper genital tract. Don't do it! Steve -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Efrain Ramirez Sent: Sunday, 18 November 2007 8:23 PM To: Multiple recipients of list OB-GYN-L Subject: Re: 2am roundtable discussions At Sat, 17 Nov 2007, AllanHo@aol.com wrote: >This reminds me of another related clincal practice. During the early part >of my resdiency, we used to check the uterine scar from the vagina after a >VBAC. We also stopped doing that rountinely if there was no abnormal bleeding >afterwards. >Lastly, I want to share a clinical practice that I do (without being >taught). After a cesarean section, I always do a vaginal exam after closing up the >patient. I do that because I want to make sure the cervix is open and that >no blood clot is left inside the uterus. During residency, I was taught to >push a pair ring forceps from above through the cervix to make sure the cervix >is open. But I didn't like it as I feel more contamination may be brought up >from the vagina. Doing a vaginal exam myself may take another minute or >two, but it reduces the chance of being called back later for a problem. > >Allan 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: Garry E. Siegel, M.D.: "Gen: Fiber" Previous message: aditi desai: "Re: 2am roundtable discussions" In reply to: Efrain Ramirez: "Re: 2am roundtable discussions" Next in thread: ainsron: "Re: 2am roundtable discussions"

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