Document Detail

Accidental vaginal incision during cesarean section. A report of four cases.
MedLine Citation:
PMID:  11762146     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Transverse vaginal incision during cesarean section, also known as anterior vaginotomy, is a recognized entity, mostly made unintentionally. CASES: At our institution, four patients underwent a transverse vaginal incision during cesarean section over an eight-year period. In three of them, excessive bleeding required blood transfusion. In one case, only hypogastric artery ligation resulted in bleeding control. None of the patients had subsequent vaginal deliveries. CONCLUSION: The exact incidence of anterior vaginotomy is difficult to evaluate. Accidental vaginal incision occurs mostly following a prolonged second stage of labor but is possible during the first stage. Risk factors include prolonged second stage of labor and an emergency setup. Reported complications resulting from anterior vaginotomy include excessive hemorrhage, with a possible need for hysterectomy, difficult approximation, and bladder or ureter injury. Massive bleeding and multiple blood transfusions occurred in our series as well. Fetal outcome and future obstetric behavior do not seem to be compromised. A high index of suspicion is essential when trying to avoid accidental anterior vaginotomy. Meticulous hemostasis, a search for bladder injury and anatomic closure are mandatory when managing this complication.
L Gortzak-Uzan; A Walfisch; Y Gortzak; M Katz; M Mazor; M Hallak
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  46     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-12-12     Completed Date:  2002-03-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1017-20     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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MeSH Terms
Cesarean Section / adverse effects*
Medical Errors / adverse effects*
Vagina / injuries*
Comment In:
J Reprod Med. 2002 Aug;47(8):693-4; author reply 694   [PMID:  12216441 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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