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Re: OB: Fourth Degree Lacerations From: Bernard Cristalli (bcrist@club-internet.fr) Tue May 25 00:25:19 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Peter Wein: "Re: OB: Fourth Degree Lacerations" Previous message: Tim or Jude Kurokawa: "Re: "Non-gowns"" Maybe in reply to: Garry E. Siegel, M.D.: "OB: Fourth Degree Lacerations" Next in thread: Dr Eberhard W Lisse: "Re: OB: Fourth Degree Lacerations" Garry E. Siegel, M.D. wrote: > I had to perform a low forceps with rotation recently, 0A, +3, and used my all > time favorite forceps, Kiellands, but unfortunately got a 4th degree > laceration on top of my episiotomy. > > This brought up a couple of things to discuss: > > 1. Should we offer a patient a C/S when you know that you can deliver > vaginally, but that the risk of laceration is higher, such as in this case? > -- no, the risk is high each time > 2. When you get a 4th degree, what tricks do you use to repair it? --thread, needles, gloves... prophylactic antibiotherapy (2 grs Augmentin®) continuous 3/0 Vicryl® layer on the rectal mucosa continuous 2/0 Monocryl® layer on the vaginal mucosa and the rest as usual 3) What tricks do I use to avoid it -- do the episiotomy at the last moment for the epis is a risk factor for severe lacerations -- Bernard Cristalli MD CNGOF AMACOG AIHP - ACCA Paris - France http://www.obgyn.net/corresp/cristalli.htm http://www.cliniquedelessonne.fr/ Next message: Peter Wein: "Re: OB: Fourth Degree Lacerations" Previous message: Tim or Jude Kurokawa: "Re: "Non-gowns"" Maybe in reply to: Garry E. Siegel, M.D.: "OB: Fourth Degree Lacerations" Next in thread: Dr Eberhard W Lisse: "Re: OB: Fourth Degree Lacerations"

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