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Re: Delivery mode in a patient with a previous rectovaginal fistulaFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Sun Aug 31 19:56:38 1997
At Sun, 31 Aug 1997, Dr. A. Hensenne wrote: > >"""I think, that the condition of the >recto-vaginal septum after repair of a fistula is probably not terribly >different from that after repair of a 4th degree tear. ..." > >I disagree with you. > If I were to deliver her vaginally, which I advocate, I would try to avoid an episiotomy, and would not attempt to repair the RV fistula at the time. I would not purposely attempt the fistula repair because the conditions in the delivery room or LDR suite are not generally a proper environment for this type of surgery, ie prepped, good lighting, suction, assistants, appropriate anesthesia unless an excellent epidural, bowel prep, antibiotics, etc. My $.02 Garry
-- Garry E. Siegel, M.D., FACOG Private Practice Roswell, Ga.
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