Patient will not need to necessarily stay longer than for delivery
However, some patients may not want another epidural/spinal Sometimes, patients can keep their epidural from labor/birth Most procedures are done with neuraxial anesthesia Usually, will have a type and screen on file already as patients are admitted for delivery (but should have this definitely) Sometimes, if there is significant blood loss with delivery, providers may want to get a CBC No additional work up usually beyond prenatal care and delivery Not a strict contraindication for surgery, but should go into counseling of patientsĬan decide to proceed or not if fundus is easily palpable This can help determine if there will be significant intrabdominal adhesions that may prevent surgery MA-31 - 30 day consent! For those with state insuranceĪsk specifically about history of abdominal surgeries and pelvic infections (ie. Lastly, it is possible that we enter the abdomen but cannot perform the surgery because we can’t find the tubes, usually due to adhesionsĪlternatives: no sterilization procedure or use a different form of birth control until 6 weeks postpartum for a laparoscopic procedure
chorio/endometritis), inability to palpate the fundus after deliveryĬan also be an issue for patients with increased central adiposity Risks: as with all surgeries, there are risks of bleeding, infection, injury to organs around the uterus and fallopian tubesĪnother big risk I tell people: we can’t perform the surgery that they want after deliveryĪ few major reasons: significant anemia after delivery, infection (ie. Review the way the procedure is done and discuss the different methods that you can provide.ĭiscuss the risks, benefits, and alternativesīenefits: stated above, quick recovery usually Today we will focus on the surgical stepsįor pictures, we still like Atlas of Pelvic Surgery: Mostly minimally invasive: not laparoscopy, but can be done through a single, mini-lap incision below the belly button as the fundus of the uterus is still high Increased access: patients are already in the healthcare setting after delivery of their baby don’t have to come back to the hospital/healthcare setting for a different procedure Highly effective: risk of pregnancy is <1% (though if you want to look at the actual rates depending on type of surgery, please check out the CREST study! Usually done within 1-2 days after vaginal delivery Procedure done after birth of a baby to permanently prevent future pregnancy
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