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Re: low transverse c/sec with vertical extensionFrom: Marco A. Pelosi, III, MD (marcop@tao.agoron.com)Mon Jun 29 18:09:18 1998
At Mon, 29 Jun 1998, SaraLieb@aol.com wrote: > >I recently had a client enter my practice who is a 33 Y.O. G2P1000 ,adopted >her 1st child out at 19 Y.O. She has a c/sec for a footling breech, unknown >weight. Upon reviewing the operative report I found that a 6cm vertical >incision was made because "the head would not fit through the Pfannenstiel >incision". >My question is this - Can I attempt a vaginal delivery or does this absolutely >require a repeat section. This woman is in good health , no present >obstetrical problems, and really desires a vaginal birth. >I'm a CNM and would really like some input on this. My own feeling is that a >6cm extension is fairly small and this occurred 14 years ago. I'd like to >proceed with the V-BAC. What do you think? >Sara Liebling, CNM saralieb@aol.com >407-331-8333 In obstetrics, optimism is the kiss of death and ignorance is the coup de grace. You would be well-advised to have ALL operative reports regarding complicated surgical deliveries reviewed by an obstetrical surgeon trained and experienced in their performance prior to utilizing such data for decision making. There is often much to be gleaned from the tenor of the narrative that may not be immediately apparent to the uninitiated.
-- M.A. Pelosi, III, MD
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