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Re: Vaginal C-sectionFrom: Robert Brenner (robbrenner@earthlink.net)Mon Nov 18 06:29:33 1996
At 07:14 AM 11/14/96 -0600, you wrote: >Are you referring to "Laparoelytrotomy" which is an abdominal wall >incision followed by mobilisation of the bladder and then an incision into >the vagina ??? >If so this is seldom extraperitoneal and can only be done if the cervix >is completely dilated. When done it is usually by accident and many times >never even recognized by the surgeon. This is usually a patient who gets >to complete dilatation and then pushes for 3-4 hours without descent. In >this situation the cervix retracts upwards and the vagina is where the >lower uterine cervix "ought to be". The main thing about recognizing it is >that it is not a contraindication to trial of labor the next time since >no uterine incision was made. There was just an article in the Clinical Opinion section of Obstetrics and Gynecology by Dr. Robert Goodlin describing this procedure and suggesting it as a possible answer to preventing the occurrence of a uterine scar so that subsequent VBAC will be safer. I think it was within the past 3 months. I must say I was rather flabbergasted at the idea. I'd be interested in hearing other comments.
-- Robert Brenner FACOG Baltimore MD Robbrenner@earthlink.net
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