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Re: 38 weeks, 2 previous myomectomiesFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Mon Dec 22 19:51:12 1997
At Mon, 22 Dec 1997, Jane Helwig, MD wrote: > >G1P0 patient, 2 previous abdominal myomectomies 2 and 12 years ago, now >38 weeks. One op report states endometrial cavity not entered, the >other doesn't say. Do we schedule c/s or labor? > >-- >Jane Helwig, MD >Private practice >Nassawadox, VA > When in doubt, cut it out. I would suggest that you have a conversation with this patient, and tell her that labor without her op note is unknown territory; furthermore, I would submit to you that someone who has had 2 myomectomies might be at a greater risk than someone who has just had one. I realize that they may have been solitary myomas, or subserousal, or pedunculated, but you just don't know. Thus, the safest thing is a section, realizing that an "unnecessary section" is a morbid procedure when compared to a vaginal delivery. Sorry to bring it up, but have you just assumed her care? I contend that this issue should have been raised with her a long time ago. Garry
-- Garry E. Siegel, M.D., FACOG Private Practice Roswell, Ga.
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