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Re: Adequate pap smears on large, obese women From: Hugo D. Ribot Jr., M.D. (hribot@mindspring.com) Mon Jun 22 00:57:56 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: J. Hellriegel: "Re: OB: Term PROM was ..You're not going to believe this.." Previous message: Bernard Cristalli: "Re: Adequate pap smears on large, obese women" In reply to: Ann Diehl, ARNP: "Adequate pap smears on large, obese women" Next in thread: Garry E. Siegel, M.D.: "Re: Adequate pap smears on large, obese women--RIBOT MANEUVER" Reply: Garry E. Siegel, M.D.: "Re: Adequate pap smears on large, obese women--RIBOT MANEUVER" Dear Ms. Diehl: Where I practice I have a disturbingly high number of patients who are in the *superbig* category (> 300 lbs) and I have found a neat trick which works amazingly well for this exact problem. What I have the patients do is get almost in a McRobert's maneuver type of position, where they grab on to their anterior shins just below the knees and pull their legs back toward either side of their chest as far as they can. This seems to tilt their pelvis anteriorly, and the result is that the cervix then faces toward the introitus, sometimes so dramatically that I can easily visualize and reach their cervix even without resorting to the usual superlong Pedersen speculum! Try it, and be sure to explain to the patients why you are asking them to assume an even less dignified position than usual; most are very understanding and actually grateful that you didn't have to pinch and push the speculum so far in or open so widely... -- Hugo Hugo D. Ribot Jr., M.D., FACOG Cartersville, Georgia Private practice in a 2 MD, 2 CNM group Next message: J. Hellriegel: "Re: OB: Term PROM was ..You're not going to believe this.." Previous message: Bernard Cristalli: "Re: Adequate pap smears on large, obese women" In reply to: Ann Diehl, ARNP: "Adequate pap smears on large, obese women" Next in thread: Garry E. Siegel, M.D.: "Re: Adequate pap smears on large, obese women--RIBOT MANEUVER" Reply: Garry E. Siegel, M.D.: "Re: Adequate pap smears on large, obese women--RIBOT MANEUVER"

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