Laparoelytrotomy or abdominal delivery without uterine incision

Goodlin, Robert C.; Scott, Joseph C.; Woods, Ralph E.; Anderson, Joseph C.

doi:10.1016/0002-9378(82)90200-9

Cited by 10 publications

(8 citation statements)

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“…It may lead to maternal morbidity such as traumatic postpartum hemorrhage, injury to the bladder/ureters and difficulty in reconstructing the vagina. [1][2][3][4][5][6] The upper uterine segment has the peritoneum adhered to it. It is quite difficult if not impossible to separate the peritoneum from the uterus here.…”

Section: Discussionmentioning

confidence: 99%

Inadvertent laparoelytrotomy in second stage of labour: a case report

Mohanty¹,

Marandi²,

Chhatria³

2021

Int J Reprod Contracept Obstet Gynecol

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Laparoelytrotomy is the accidental delivery via a vaginal incision during caesarean section in second stage of labour. It refers to the inadvertent delivery of the foetus through a transverse incision given over the vagina during a caesarean section (C-section). It is a rather uncommon complication of C-section encountered at advanced dilation which can lead to maternal complications such as traumatic postpartum hemorrhage, injury to bladder, ureters and difficult reconstruction of vagina. Here, we present a case report of inadvertent laparoelytrotomy during C-section.

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Section: Discussionmentioning

confidence: 99%

Inadvertent laparoelytrotomy in second stage of labour: a case report

Mohanty¹,

Marandi²,

Chhatria³

2021

Int J Reprod Contracept Obstet Gynecol

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“…The operation was abandoned because of lack of success. Laparoelytrotomy has only been brie¯y mentioned in the modern obstetric literature 3,4 . The four cases described here occurred by accident during caesarean sections performed by experienced surgeons thinking they had made a transverse incision into the lower uterine segment.…”

Section: Discussionmentioning

confidence: 99%

Accidental delivery through a vaginal incision (laparoelytrotomy) during caesarean section in the second stage of labour

Peleg¹,

Perlitz²,

Pansky³

et al. 2001

British Journal of Obstetrics and Gynaecology

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A 33 year old woman was admitted at 41 weeks of gestation for induction of labour. Her previous delivery was by caesarean section for fetal distress. The present pregnancy was uncomplicated. The estimated fetal weight by sonogram was 3900 grams. The woman received vaginal prostaglandin E 2 followed by oxytocin and entered active labour. Epidural anaesthesia was used. She progressed to full dilatation of the cervix. The infant's head remained at 12 station despite adequate contractions, and we decided to perform a caesarean section. A low transverse incision was used to deliver a healthy girl weighing 3820g. The uterus was exteriorised for closure. Only after complete closure of the incision did it become evident that a free vaginal¯ap was present. The original closure, which had sewn the free edges of the cervix together, was taken down. The free edge of the anterior vaginal wall was then sewn 1 cm proximal to the free edge of the anterior cervix, reforming a fornix between the two. The remainder of the operation was without incident. Estimated blood loss was 1000mL. The woman's postpartum course was uncomplicated and she was discharged on her fourth post-operative day. Case report 2A 33 year-old woman was admitted in labour at 41 weeks of gestation. Her pregnancy was uncomplicated. She had a history of ulcerative colitis which was in remission. She progressed to 8 cm dilatation and the infant's head was at 0 station. At this point delay in the ®rst stage of labour occurred, and we decided to perform a caesarean section. The lower uterine segment was noted to be extremely thin. A baby boy weighing 3380g was born. After delivery, examination of the incision revealed an elytrotomy. Closure was performed by sewing the vagi-nal¯ap 1 cm proximal to the free cervical lip. Estimated blood loss was 700mL. Recovery was uneventful, and she was discharged on her fourth post-operative day. Cases report 3 & 4A 24 year old who was admitted for induction of labour at 41 12 weeks of gestation because of suspected macrosomia. At 13 weeks of gestation, she had had a laparotomy due to peritonitis following perforation of a jejunal stump created during a previous cholecystectomy. Following two doses of vaginal prostaglandin E 2 , labour began. She progressed steadily to full dilatation of the cervix. She developed delay in the second stage of labour, with the infant's head remaining high in the pelvis. A caesarean section was performed, and a baby boy weighing 4280g was born, following which we discovered the elytrotomy.A 36 year-old woman who was admitted with rupture of the membranes and contractions at 41 14 weeks of gestation. In a previous pregnancy she had had a caesarean at 40 weeks of gestation due to a breech presentation, but subsequently had two normal vaginal deliveries. Her labour progressed rapidly to full dilatation of the cervix, but the infant's head remained high. A caesarean section was performed, and a baby boy was delivered, following which we discovered the elytrotomy.Both these vaginal incisions were repaired ...

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“…The operation was abandoned because of lack of success. Laparoelytrotomy has only been briefly mentioned in the modern obstetric literature 3,4 . The four cases described here occurred by accident during caesarean sections performed by experienced surgeons thinking they had made a transverse incision into the lower uterine segment.…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that laparoelytrotomy may be performed electively with reduced bleeding, by displacing the bladder further caudally, exposing a 4 cm segment of the anterior vaginal wall 2,3 . However, there have been no follow up reports nor have there been any reports of subsequent deliveries in these women.…”

Section: Discussionmentioning

confidence: 99%

Accidental delivery through a vaginal incision (laparoelytrotomy) during caesarean section in the second stage of labour

Peleg

Perlitz

Pansky

et al. 2001

BJOG

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A 33 year old woman was admitted at 41 weeks of gestation for induction of labour. Her previous delivery was by caesarean section for fetal distress. The present pregnancy was uncomplicated. The estimated fetal weight by sonogram was 3900 grams. The woman received vaginal prostaglandin E 2 followed by oxytocin and entered active labour. Epidural anaesthesia was used. She progressed to full dilatation of the cervix. The infant's head remained at 12 station despite adequate contractions, and we decided to perform a caesarean section. A low transverse incision was used to deliver a healthy girl weighing 3820g. The uterus was exteriorised for closure. Only after complete closure of the incision did it become evident that a free vaginal¯ap was present. The original closure, which had sewn the free edges of the cervix together, was taken down. The free edge of the anterior vaginal wall was then sewn 1 cm proximal to the free edge of the anterior cervix, reforming a fornix between the two. The remainder of the operation was without incident. Estimated blood loss was 1000mL. The woman's postpartum course was uncomplicated and she was discharged on her fourth post-operative day. Case report 2A 33 year-old woman was admitted in labour at 41 weeks of gestation. Her pregnancy was uncomplicated. She had a history of ulcerative colitis which was in remission. She progressed to 8 cm dilatation and the infant's head was at 0 station. At this point delay in the ®rst stage of labour occurred, and we decided to perform a caesarean section. The lower uterine segment was noted to be extremely thin. A baby boy weighing 3380g was born. After delivery, examination of the incision revealed an elytrotomy. Closure was performed by sewing the vaginal¯ap 1 cm proximal to the free cervical lip. Estimated blood loss was 700mL. Recovery was uneventful, and she was discharged on her fourth post-operative day. Cases report 3 & 4A 24 year old who was admitted for induction of labour at 4112 weeks of gestation because of suspected macrosomia. At 13 weeks of gestation, she had had a laparotomy due to peritonitis following perforation of a jejunal stump created during a previous cholecystectomy. Following two doses of vaginal prostaglandin E 2 , labour began. She progressed steadily to full dilatation of the cervix. She developed delay in the second stage of labour, with the infant's head remaining high in the pelvis. A caesarean section was performed, and a baby boy weighing 4280g was born, following which we discovered the elytrotomy.A 36 year-old woman who was admitted with rupture of the membranes and contractions at 41 14 weeks of gestation. In a previous pregnancy she had had a caesarean at 40 weeks of gestation due to a breech presentation, but subsequently had two normal vaginal deliveries. Her labour progressed rapidly to full dilatation of the cervix, but the infant's head remained high. A caesarean section was performed, and a baby boy was delivered, following which we discovered the elytrotomy.Both these vaginal incisions were repaired a...

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Laparoelytrotomy or abdominal delivery without uterine incision

Cited by 10 publications

References 0 publications

Inadvertent laparoelytrotomy in second stage of labour: a case report

Inadvertent laparoelytrotomy in second stage of labour: a case report

Accidental delivery through a vaginal incision (laparoelytrotomy) during caesarean section in the second stage of labour

Accidental delivery through a vaginal incision (laparoelytrotomy) during caesarean section in the second stage of labour

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