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Re: Vaginal laceration during C-sectionFrom: Marco A. Pelosi, III, MD (marcop@tao.agoron.com)Tue Oct 28 22:15:02 1997
At Tue, 28 Oct 1997, Jeff Ruderman, M.D. wrote: > >Has anyone had or heard of a cervical extension of a low transverse >incision during a Cesarian delivery, which extended into the patient's >vagina? A couple of years ago, Goodlin published a series of second-stage cesarean sections in which the anterior vaginal fornix was mistaken for the lower uterine segment. These infants thus, were all delivered through an inadvertent anterior colpotomy. Despite mobilization of the bladder, the danger to the ureters is obvious. At the turn of the century, Duhrssen and Solms introduced a short-lived hybrid of the extraperitoneal and transvaginal cesarean sections which they termed laparo-colpohysterotomy. The procedure involved splitting the cervix at 12:00 through a transvaginal anterior colpotomy without entering the peritoneal cavity. An abdominal incision was then made, the rectus muscles were retracted laterally and the bladder was mobilized from the uterus without opening the peritoneum. Eventually, the anterior colpotomy was reached from the top. The split cervix was lifted over the symphysis pubis, the incision was extended onto the lower segment and the infant was delivered by forceps.
-- M.A. Pelosi, III, MD
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