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Re: Delivery mode in a patient with a previous rectovaginal fistulaFrom: Ronald R Helm (rrhelm@juno.com)Sat Aug 30 16:54:22 1997
On Sat, 30 Aug 1997 16:32:57 -0500 Dr Eberhard W Lisse <el@linux.lisse.na> writes: >Philip, > >[...] >> She presented to me, now pregnant! I did a MEDLINE search and there >is >> nothing in the literature about delivery in a patient with an ACTIVE >RV >> fistula. My partners and I decided that the best course was >probably to >> allow her to labor and have a repair attemtped removed from the >> postpartum period unless a vaginal laceration occurs. > >Vaginal Bypass. > >Why worsen the fistula/tear? > >el Yet another indication for Cesarean section. I can agree with Cesarean for a successfully repaired RV fistula, but your rationale for Cesarean in the presence of an RV fistula (why worsen the fistula/tear) is similar to doing a Cesarean on anyone who has ever had a third or fourth degree tear. Condescendingly and annoyingly yours, Ron
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