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Re: 38 weeks, 2 previous myomectomies From: Malcolm Griffiths (Malcolm@mgriff22.demon.co.uk) Tue Dec 23 02:06:47 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: JANE T MONTGOMERY: "OB: Uterine Incarceration" Previous message: Malcolm Griffiths: "GEN: 56K modems" In reply to: Garry E. Siegel, M.D.: "Re: 38 weeks, 2 previous myomectomies" Next in thread: Marco A. Pelosi, III, MD: "Re: 38 weeks, 2 previous myomectomies" In message <199712230251.UAA16091@talk.obgyn.net>, "Garry E. Siegel, M.D." <garrys@mindspring.com> writes >> >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. To some extent all labours (esp primips) are unknown territory! > >Thus, the safest thing is a section, realizing that an "unnecessary >section" is a morbid procedure when compared to a vaginal delivery. > I'm unconvinced that CS is necessarily guaranteed to be the safest. Whilst acknowledging that with a VBAC attempt there is (probabaly) a very small risk of major problems, one cannot be certain that an elective CS will be guaranteed safe and trouble free. >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. > Agreed! Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt Obstetrician & Gynaecologist Luton & Dunstable Hosp.,UK. Tel: 01582-497459 (office) Fax: 01582-497376 01525-222849 (home) email: Malcolm@mgriff22.demon.co.uk http://www.obgyn.net/board/griffith.htm "CLINICAL FREEDOM IS THE LAST REFUGE OF THE CLINICALLY INCOMPETENT!" (Someone [1997]) Next message: JANE T MONTGOMERY: "OB: Uterine Incarceration" Previous message: Malcolm Griffiths: "GEN: 56K modems" In reply to: Garry E. Siegel, M.D.: "Re: 38 weeks, 2 previous myomectomies" Next in thread: Marco A. Pelosi, III, MD: "Re: 38 weeks, 2 previous myomectomies"

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