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Would you use a pessary?From: AlliesMa@aol.comThu May 16 19:15:45 1996
Pt is a G2P1001 now 6.5 wks pregnant with a history of an incarcerated uterus in her prior pregnancy. It was not diagnosed until 17 wks when she went into urinary retention. Prior incarceration was not easily reduced. Knee chest position, manual reduction vaginally, rectally and by the perinatologist with vag probe of US all failed. Successful reduction was utimately obtained at about 19 weeks, manually - but with the use of an epidural. Pap smear done several months after pregnancy revealed the uterus to again be in a severely retroverted position. Pt seen today at 6.5 wks and uterus again severely retroverted and difficult to bring out of the pelvis. Attempted to place a Hodge pessary which did seem to bring the uterus into a more anterior position, but did not have the correct size. Plan on ordering a different size and placing next week. Does anyone have any experience with this? Does this seem like a reasonable attempt to avoid incarceration again? There is very little in the literature regarding recurrence rates of uterine incarceration. Open to any suggestions. Thanks for your help. C. Burkhardt York, PA
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