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Re: Muscle splitting/mobilising incisions From: Bernard Cristalli (bcrist@club-internet.fr) Sun Aug 17 13:46:13 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Bernard Cristalli: "Re:References: <199708150729.JAA20472@dante.linknet.it>" Previous message: Ronald R Helm: "Re: Triplets delivery" Maybe in reply to: Malcolm Griffiths: "Muscle splitting/mobilising incisions" Next in thread: Lynn Montgomery: "Re: Muscle splitting/mobilising incisions" Malcolm Griffiths wrote: > > I did a emeregency CS today on a woman who was in her second pregnancy. > She had previously had priamry infertility. I don't know thje details > but she had tubal surgery under a colleague in London, who is known to > use a transverse abdo incision during which he either divides the rectus > muscle transversely or strips it off the pubic bone. > > This morning at 07.30 she comes in established labour with spont ROM, > meconium, difficult to record CTG and confirmed transverse lie, high > pres part on ve, with cervix 1cm dilated. She is 5'9" tall, not obese > and with no previous (other) surgery. > > I decide to do CS !!! > You did well!! > > At op there is no rectus muscle !!! !!! > > I go through sheath and find it adherent to peritoneum without any > intervening muscle. I then go one to complete delivery through a poorly > formed thick conical lower segment. Baby is fine. > > Questions: > > 1) Anyone come across this incision for tubal surgery ? I carry on doing Pfanns except if I want a very large access without a midline. This transverse incision has been popularised again by Jack Mouchel. It's a variant of old Cherney, Thoyer-Rozat aso. > > 2) Does anyone think that doing such an incision may lead to rectus > problems ? Supposed not > > 3) Was the rectus deficiency yhr cause for transeverse lie ??? Good question. I don't know. Is transverse lie more frequent in myopathic women (without malposition)? -- Bernard Cristalli MD CNGOF AIHP - ACCA Paris - France http://www.obgyn.net/corresp/cristalli.htm Next message: Bernard Cristalli: "Re:References: <199708150729.JAA20472@dante.linknet.it>" Previous message: Ronald R Helm: "Re: Triplets delivery" Maybe in reply to: Malcolm Griffiths: "Muscle splitting/mobilising incisions" Next in thread: Lynn Montgomery: "Re: Muscle splitting/mobilising incisions"

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