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Re: Placenta AccretaFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Sun Feb 17 07:15:13 2008
At Sun, 17 Feb 2008, Dr Eberhard W Lisse wrote: > >Well, our cows are quite sane, but I think the resorption is by >enzymatic breakdown whereas >Vicryl is resorbed by hydrolysis. > >el > >On Feb 17, 2008, at 12:12, Bernard Cristalli wrote: > >> Catgut isn't available around here. >> Because of BSE. Thank god Chromic is still available in Canada, if you truly understand its elasticity than you will understand how it can be helpful for PPH during a c-section or for bleeding from a vascular placental bed. My original post on placenta accreta did not make it through, basically I have done about 4, my thoughts are if it’s in the fundus than things will go well no matter how you handle it including leaving the placenta, if its stuck in the lower uterine segment than be prepared for a difficult time no matter what approach and precautions including uterine artery emobilization you take. The patient was a P2 I would not be surprised if she had had a previous c-section. A placenta accreta in the lower segment is a good reason for a classical section.
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Take care, John
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