Dilation Issues Pts w/ Prior Cryo

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Have you seen/heard of patients who have had trouble during labor/delivery due to cervix not dilating properly after having had a cryo done (for abnormal pap / dysplasia) in the past? Heard of this recently and wanted to see how common this is/isn't.

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Absolutley! I have seen this many times. When you do the VE you can feel the scar tissue, and they tend to bleed more through/after delivery. I have noticed it can take some time to get the cervix to start to dilate. Not all patients are the same. I have found that multiple TA's can do the same. Most do end up delivered lady partslly though.

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Specializes in Nurse Manager, Labor and Delivery.

These poor patients can have the most miserable prodromal labor because of the scar tissue that has built up around the cervix. They contract and contract and never seem to dilate. Once the scar tissue is "popped" they are good to go.

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Specializes in Adult ICU (All over), NICU, Education.

I had this problem...A nurse actually manually stretched my cervix...that was more painful that anything else during labor. I went from being 1 cm for over 12 hours to 3 cms after she "streched" my cervix to delivering 4 hours later.

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My cousin actually had this happen, but prior to the actual delivery, she'd never heard of there being any potential issues...so she was quite surprised when the midwife asked her hey have you had a cryo done? And then explained that the scar tissue was preventing the cervix from dilating. I myself have had a cryo done (about 5 years ago) and wonder how that will affect my delivery. From what my cousin tells me, she remembers them cutting????? her cervix but I'm sure that's not what they did, she probably just wasn't sure what was going on at that point. I have heard about sort of massaging the scar tissue and then it not being an issue in further deliveries once the scar tissue has been broken up. I'm a bit nervous about this I'll confess! Any indication it leads to a higher incidence of c-section? I noticed a few posters above say that most pts deliver lady partslly after the scar tissue is broken up, I hope that's the case for me!

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Specializes in OB.

The other issue I've found is that once the scar tissue "gives" these patients can then progress quite rapidly and occasionally precip on you. Once they start changing their cervix make sure you are set up.

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What about pt's that have had a cone biopsy? Does this leave the same scar tissue as a cryo? I am new to L&D, and the other day at work we had a patient (antepartum) that had a previous cone biopsy. We were discussing the risks of preterm labor, carrying the baby, scar tissue, etc. What has been your experiences with this?

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