Indications for forceps and vacuum extractor are essentially the same. These problems usually improve within weeks but might persist long term. Every delivery is unique and may differ from mothers to mothers. Labour is initiated through drugs or manual techniques. Delivery Room Procedures Following a Normal Vaginal Birth As your baby lies with you following a routine delivery, her umbilical cord still will be attached to the placenta. Read more about the types of midwives available. Another type of episiotomy is a mediolateral incision made from the midpoint of the fourchette at a 45 angle laterally on either side. For the first hour after delivery, the mother should be observed closely to make sure the uterus is contracting (detected by palpation during abdominal examination) and to check for bleeding, blood pressure abnormalities, and general well-being. Search dates: September 4, 2014, and April 23, 2015. This type usually does not extend into the sphincter or rectum (5 Delivery of the fetus references Many obstetric units now use a combined labor, delivery, recovery, and postpartum (LDRP) room, so that the woman, support person, and neonate remain in the same room throughout their stay. For manual removal, the clinician inserts an entire hand into the uterine cavity, separating the placenta from its attachment, then extracts the placenta. Clamp cord with at least 2-4 cm between the infant and the closest clamp. Postpartum maternal and neonatal outcomes can be improved through delayed cord clamping, active management to prevent postpartum hemorrhage, careful examination for external anal sphincter injuries, and use of absorbable synthetic suture for second-degree perineal laceration repair. When describing how a pregnancy is dated, by last menstrual period means ultrasonography has not been performed, by X-week ultrasonography means that the due date is based on ultrasound findings only, and by last menstrual period consistent with X-week ultrasound findings means ultrasonography confirmed the estimated due date calculated using the last menstrual period. After delivery, skin-to-skin contact with the mother is recommended. Some read more ) tend to be more common after forceps delivery than after vacuum extraction. Encourage the mother to void before delivery to reduce the discomfort. Do not discontinue an epidural late in labor in an attempt to avoid assisted vaginal delivery. . However, spontaneous vaginal deliveries are not advised for all pregnant women. When the head is delivered, the clinician determines whether the umbilical cord is wrapped around the neck. Remove loose objects (e.g. Promote walking and upright positions (kneeling, squatting, or standing) for the mother in the first stage of labor. Some read more ). Spontaneous expulsion, of a single,mature fetus (37 completed weeks 42 weeks), presented by vertex, through the birth canal (i.e. Please confirm that you are a health care professional. Oxytocin should not be given as an IV bolus because cardiac arrhythmia may occur. (2014). Although delayed pushing or laboring down shortens the duration of pushing, it increases the length of the second stage and does not affect the rate of spontaneous vaginal delivery.24 Arrest of the second stage of labor is defined as no descent or rotation after two hours of pushing for a multiparous woman without an epidural, three hours of pushing for a multiparous woman with an epidural or a nulliparous woman without an epidural, and four hours of pushing for a nulliparous woman with an epidural.8 A prolonged second stage in nulliparous women is associated with chorioamnionitis and neonatal sepsis in the newborn.25. Treatment depends on etiology read more , which is a leading cause of maternal morbidity and mortality. The doctor will explain the procedure and the possible complications to the mother 2. This occurs after a pregnant woman goes through. Oxytocin should not be given as an IV bolus because cardiac arrhythmia may occur. The delivery of the placenta is the third and final stage of labor; it normally occurs within 30 minutes of delivery of the newborn. For the first hour after delivery, the mother should be observed closely to make sure the uterus is contracting (detected by palpation during abdominal examination) and to check for bleeding, blood pressure abnormalities, and general well-being. A. A vaginal examination is done to determine position and station of the fetal head; the head is usually the presenting part (see figure Sequence of events in delivery for vertex presentations Sequence of events in delivery for vertex presentations ). This article is one in a series on Advanced Life Support in Obstetrics (ALSO), initially established by Mark Deutchman, MD, Denver, Colo. If appropriate traction and maternal pushing do not deliver the anterior shoulder, the clinician should explain to the woman what must be done next and begin delivery of a fetus with shoulder dystocia Shoulder dystocia Fetal dystocia is abnormal fetal size or position resulting in difficult delivery. After delivery of the head, the infants body rotates so that the shoulders are in an anteroposterior position; gentle downward pressure on the head delivers the anterior shoulder under the symphysis. Feelings of fear, nervousness, and tension can cause the release of adrenaline and slow the labor process. It's typically diagnosed after an individual develops multiple pregnancies at once. If the nuchal cord is loose, it can be gently pulled over the head if possible or left in place if it does not interfere with delivery. Epidural analgesia, which can be rapidly converted to epidural anesthesia, has reduced the need for general anesthesia except for cesarean delivery. Delivery type. Obstet Gynecol 121(1):122128, 2013. doi: 10.1097/AOG.0b013e3182749ac9. Data Sources: A PubMed search was completed in Clinical Queries using key terms including labor and obstetric, delivery and obstetric, labor stage and first, labor stage and second, labor stage and third, doulas, anesthesia and epidural, and postpartum hemorrhage. The technique involves injecting 5 to 10 mL of 1% lidocaine or chloroprocaine (which has a shorter half-life) at the 3 and 9 oclock positions; the analgesic response is short-lasting. Place the tip of the middle finger at the sacral promontory and note the point on the hand that contacts the pubic symphysis (Figure 162-1B). These drugs pass through the placenta; thus, during the hour before delivery, such drugs should be given in small doses to avoid toxicity (eg, central nervous system [CNS] depression, bradycardia) in the neonate. Compared to other methods of childbirth, such as a cesarean delivery and induced labor, its the simplest kind of delivery process. The search included meta-analyses, randomized controlled trials, clinical trials, and reviews. 2005-2023 Healthline Media a Red Ventures Company. Management guided by current knowledge of the relevant screening tests and normal labor process can greatly increase the probability of an uncomplicated delivery and postpartum course. The mother can usually help deliver the placenta by bearing down. It is also known as a vaginal birth. LEE T. DRESANG, MD, AND NICOLE YONKE, MD, MPH. There's conflicting information out there so we look, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. The vigorous newborn should be placed directly in contact with the mother's skin and covered with a blanket. The 2nd stage of labor is likely to be prolonged (eg, because the mother is too exhausted to bear down adequately or because regional epidural anesthesia inhibits vigorous bearing down). Some read more ) and anal sphincter injuries (2 Delivery of the fetus references Many obstetric units now use a combined labor, delivery, recovery, and postpartum (LDRP) room, so that the woman, support person, and neonate remain in the same room throughout their stay. When epidural analgesia is used, drugs can be titrated as needed during the course of labor. Latent labor lasting many hours is normal and is not an indication for cesarean delivery.68 Active labor with more rapid dilation may not occur until 6 cm is achieved. (See also Postpartum Care and Associated Disorders Postpartum Care Clinical manifestations during the puerperium (6-week period after delivery) generally reflect reversal of the physiologic changes that occurred during pregnancy (see table Normal Postpartum read more .). The mechanism of this intervention has been the extinction procedure in Pavlovian conditioning, and this application has provided many successful instances for the prevention of relapse. Labor opens, or dilates, her cervix to at least 10 centimeters. Pudendal block is a safe, simple method for uncomplicated spontaneous vaginal deliveries if women wish to bear down and push or if labor is advanced and there is no time for epidural injection. Treatment depends on etiology read more , which is a leading cause of maternal morbidity and mortality. If the fetus is in the occipitotransverse or occipitoposterior position in the second stage, manual rotation to the occipitoanterior position decreases the likelihood of operative vaginal and cesarean delivery.26 Fetal position can be determined by identifying the sagittal suture with four suture lines by the anterior (larger) fontanelle and three by the posterior fontanelle. 1. Provide continuous support during labor and delivery. Some obstetricians routinely explore the uterus after each delivery. A. The tight nuchal cord itself may contribute to some of these outcomes, however.32 Another option for a tight nuchal cord is the somersault maneuver (carefully delivering the anterior and posterior shoulder, and then delivering the body by somersault while the head is kept next to the maternal thigh). Methods include pudendal block, perineal infiltration, and paracervical block. The infant is thoroughly dried, then placed on the mothers abdomen or, if resuscitation is needed, in a warmed resuscitation bassinet. With thiopental, induction is rapid and recovery is prompt. Thacker SB, Banta HD: Benefits and risks of episiotomy: An interpretative review of the English language literature, 1860-1980. Use for phrases A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Delivery bed: a bed that supports the woman in a semi-sitting or lying in a lateral position, with removable stirrups (only for repairing the perineum or instrumental delivery) . After delivery of the infant and administration of oxytocin, the clinician gently pulls on the cord and places a hand gently on the abdomen over the uterine fundus to detect contractions; placental separation usually occurs during the 1st or 2nd contraction, often with a gush of blood from behind the separating placenta. Diagnosis is clinical. Have someone take you to the hospital when you find it hard to talk, walk, or move during your contractions or if your water breaks. Induced vaginal delivery: Drugs or other techniques start labor and soften or open your cervix for delivery. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Third- and 4th-degree perineal tears (1 Delivery of the fetus references Many obstetric units now use a combined labor, delivery, recovery, and postpartum (LDRP) room, so that the woman, support person, and neonate remain in the same room throughout their stay. The most common episiotomy is a midline incision made from the midpoint of the fourchette directly back toward the rectum. Many mothers wish to begin breastfeeding soon after delivery, and this activity should be encouraged. Cesarean delivery for failure to progress in active labor is indicated only if the woman is 6 cm or more dilated with ruptured membranes, and she has no cervical change for at least four hours of adequate contractions (more than 200 Montevideo units per intrauterine pressure catheter) or inadequate contractions for at least six hours.8 If possible, the membranes should be ruptured before diagnosing failure to progress. Use to remove results with certain terms Both procedures have risks. Episiotomy is associated with more severe perineal trauma, increased need for suturing, and more healing complications.31. See permissionsforcopyrightquestions and/or permission requests. Second-degree laceration repairs are best performed in a continuous manner with absorbable synthetic suture. prostate. Mayo Clinic Staff. Normal Spontaneous Vaginal Delivery Sections Download Chapter PDF Share Get Citation Search Book Annotate Expand All Sections Full Chapter Figures Tables Videos Supplementary Content Introduction Anatomy and Pathophysiology Indications Contraindications Equipment Initial Assessment Patient Preparation Techniques Alternative Techniques Assessment Out of the nearly 4 million births in the United States in 2013, approximately 3 million were vaginal deliveries.1 Accurate pregnancy dating is essential for anticipating complications and preparing for delivery. Management of complications during delivery requires additional measures (such as induction of labor Induction of Labor Induction of labor is stimulation of uterine contractions before spontaneous labor to achieve vaginal delivery. Epidural analgesia is being increasingly used for delivery, including cesarean delivery, and has essentially replaced pudendal and paracervical blocks. Delay cord clamping for one to three minutes after birth or until cord pulsation has ceased, unless urgent resuscitation is indicated. Fitzpatrick M, Behan M, O'Connell PR, et al: Randomised clinical trial to assess anal sphincter function following forceps or vacuum assisted vaginal delivery. Both procedures have risks. LeFevre ML: Fetal heart rate pattern and postparacervical fetal bradycardia. It is used mainly for 1st- or early 2nd-trimester abortion. Obstet Gynecol 75 (5):765770, 1990. In the delivery room, the perineum is washed and draped, and the neonate is delivered. If she cannot and if substantial bleeding occurs, the placenta can usually be evacuated (expressed) by placing a hand on the abdomen and exerting firm downward (caudal) pressure on the uterus; this procedure is done only if the uterus feels firm because pressure on a flaccid uterus can cause it to invert Inverted Uterus Inverted uterus is a rare medical emergency in which the corpus turns inside out and protrudes into the vagina or beyond the introitus. An alternative to delayed clamping in premature infants is umbilical cord milking, which involves pushing blood toward the infant by grasping and squeezing (milking) the cord before it is clamped. fThe following criteria should be present to call it normal labor. Vaginal delivery is a natural process that usually does not require significant medical intervention. Copyright 2015 by the American Academy of Family Physicians. The nose, mouth, and pharynx are aspirated with a bulb syringe to remove mucus and fluids and help start respirations. The local anesthetics often used for epidural injection (eg, bupivacaine) have a longer duration of action and slower onset than those used for pudendal block (eg, lidocaine). 7. This block anesthetizes the lower vagina, perineum, and posterior vulva; the anterior vulva, innervated by lumbar dermatomes, is not anesthetized. An arterial pH > 7.15 to 7.20 is considered normal. Vaginal delivery is the most common type of birth. The link you have selected will take you to a third-party website. After delivery, the woman may remain there or be transferred to a postpartum unit. Spontaneous vaginal delivery at term has long been considered the preferred outcome for pregnancy. Shiono P, Klebanoff MA, Carey JC: Midline episiotomies: More harm than good? There are different stages of normal delivery or vaginal birth that include: In such cases, an abnormally adherent placenta (placenta accreta Placenta Accreta Placenta accreta is an abnormally adherent placenta, resulting in delayed delivery of the placenta. Paracervical block is rarely appropriate for delivery because incidence of fetal bradycardia is > 10% (1 Anesthesia reference Many obstetric units now use a combined labor, delivery, recovery, and postpartum (LDRP) room, so that the woman, support person, and neonate remain in the same room throughout their stay. brachytherapy. Spinal injection (into the paraspinal subarachnoid space) may be used for cesarean delivery, but it is used less often for vaginal deliveries because it is short-lasting (preventing its use during labor) and has a small risk of spinal headache afterward. Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT, Every delivery is as unique and individual as each mother and infant. Episiotomy, An episiotomy is a surgical cut made in the perineum during childbirth. Obstet Gynecol 64 (3):3436, 1984. Forceps or vacuum extraction is needed during a vaginal delivery How it works If you need an episiotomy, you typically won't feel the incision or the repair. (See also Postpartum Care and Associated Disorders Postpartum Care Clinical manifestations during the puerperium (6-week period after delivery) generally reflect reversal of the physiologic changes that occurred during pregnancy (see table Normal Postpartum read more .). Mother, infant, and father or partner should remain together in a warm, private area for an hour or more to enhance parent-infant bonding. o [teenager OR adolescent ], , MD, Saint Louis University School of Medicine. Pudendal block is a safe, simple method for uncomplicated spontaneous vaginal deliveries if women wish to bear down and push or if labor is advanced and there is no time for epidural injection. Diagnosis is by examination, ultrasonography, or response to augmentation of labor. Only one code is available for a normal spontaneous vaginal delivery. The diagonal conjugate refers to the distance from the inferior border of the pubic symphysis to the sacral promontory (Figure 162-1A).The normal diagonal conjugate measures approximately 12.5 cm, with the critical distance being 10 cm. Active management includes giving the woman a uterotonic drug such as oxytocin as soon as the fetus is delivered. This can occur a few weeks to a few hours from the onset of labor. Infiltration of the perineum with an anesthetic is commonly used, although this method is not as effective as a well-administered pudendal block. A local anesthetic can be infiltrated if epidural analgesia is inadequate. In the delivery room, the perineum is washed and draped, and the neonate is delivered. What are the documentation requirements for vaginal deliveries? Obstet Gynecol 121(1):122128, 2013. doi: 10.1097/AOG.0b013e3182749ac9. An arterial pH > 7.15 to 7.20 is considered normal. Women giving birth for the first time tend to go through labor for 12 to 24 hours, while women who have previously delivered a child may only go through labor for 6 to 8 hours.These are the three stages of labor that signal a spontaneous vaginal delivery is about to occur: Of the almost 4 million births that occur in the United States each year, most are spontaneous vaginal deliveries. Obstet Gynecol 75 (5):765770, 1990. About 35% of women have dyspareunia after episiotomy (7 Delivery of the fetus references Many obstetric units now use a combined labor, delivery, recovery, and postpartum (LDRP) room, so that the woman, support person, and neonate remain in the same room throughout their stay. Women may push in any position that they prefer. Bonus: You can. Induced labour An induced vaginal delivery is normal delivery involving induction of labour. As the uterus contracts, a plane of separation develops at. True B. It is the most common gastrointestinal emergency read more and intraventricular hemorrhage (however, slightly increased risk of needing phototherapy). After delivery of the head, the infants body rotates so that the shoulders are in an anteroposterior position; gentle downward pressure on the head delivers the anterior shoulder under the symphysis. Some read more ), but it causes greater postoperative pain, is more difficult to repair, has increased blood loss, and takes longer to heal than midline episiotomy (6 Delivery of the fetus references Many obstetric units now use a combined labor, delivery, recovery, and postpartum (LDRP) room, so that the woman, support person, and neonate remain in the same room throughout their stay. Professional Training. Simultaneously, the clinician places the curved fingers of the right hand against the dilating perineum, through which the infants brow or chin is felt. A spontaneous vaginal delivery is a vaginal delivery that happens on its own, without requiring doctors to use tools to help pull the baby out. Procedures; Contraception; Support; About; Index; Search for: Vaginal Delivery . Consuming turmeric in pregnancy is a debated subject. Uterotonic drugs help the uterus contract firmly and decrease bleeding due to uterine atony, the most common cause of postpartum hemorrhage. Thiopental, a sedative-hypnotic, is commonly given IV with other drugs (eg, succinylcholine, nitrous oxide plus oxygen) for induction of general anesthesia during cesarean delivery; used alone, thiopental provides inadequate analgesia. Mother, infant, and father or partner should remain together in a warm, private area for an hour or more to enhance parent-infant bonding. 59409, 59412. . Labor usually begins with the passing of a womans mucous plug. Third- and 4th-degree perineal tears (1 Delivery of the fetus references Many obstetric units now use a combined labor, delivery, recovery, and postpartum (LDRP) room, so that the woman, support person, and neonate remain in the same room throughout their stay. An alternative to delayed clamping in premature infants is umbilical cord milking, which involves pushing blood toward the infant by grasping and squeezing (milking) the cord before it is clamped. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. This content is owned by the AAFP. We avoid using tertiary references. You are in active labor when the contractions get longer, stronger, and closer together. Diagnosis is clinical. Thus, for episiotomy, a midline cut is often preferred. Sequence of events in delivery for vertex presentations, Cargill YM, MacKinnon CJ, Arsenault MY, et al, Fitzpatrick M, Behan M, O'Connell PR, et al, Towner D, Castro MA, Eby-Wilkens E, et al, Marcaine, Marcaine Spinal, POSIMIR, Sensorcaine, Sensorcaine MPF , Xaracoll, 7T Lido, Akten , ALOCANE, ANASTIA, AneCream, Anestacon, Aspercreme, Aspercreme with Lidocaine, Astero , BenGay, Blue Tube, Blue-Emu, CidalEaze, DermacinRx Lidogel, DermacinRx Lidorex, DERMALID, Ela-Max, GEN7T, Glydo, LidaMantle, Lidocare, Lidoderm, LidoDose, LidoDose Pediatric, Lidofore, LidoHeal-90, LIDO-K , Lidomar , Lidomark, LidoReal-30, LidoRx, Lidosense 4 , Lidosense 5, LIDO-SORB, Lidotral, Lidovix L, LIDOZION, Lidozo, LMX 4, LMX 4 with Tegaderm, LMX 5, LTA, Lydexa, Moxicaine, Numbonex, ReadySharp Lidocaine, RectaSmoothe, RectiCare, Salonpas Lidocaine, Senatec, Solarcaine, SUN BURNT PLUS, Tranzarel, Xylocaine, Xylocaine Dental, Xylocaine in Dextrose, Xylocaine MPF, Xylocaine Topical, Xylocaine Topical Jelly, Xylocaine Topical Solution, Xylocaine Viscous, Zilactin-L, Zingo, Zionodi, ZTlido. The woman has a disorder such as a heart disorder and must avoid pushing during the 2nd stage of labor. If appropriate traction and maternal pushing do not deliver the anterior shoulder, the clinician should explain to the woman what must be done next and begin delivery of a fetus with shoulder dystocia Shoulder dystocia Fetal dystocia is abnormal fetal size or position resulting in difficult delivery. Complications of pudendal block include intravascular injection of anesthetics, hematoma, and infection. Placental function is normal, but trophoblastic invasion extends beyond the normal boundary read more ) should be suspected. We also searched the Cochrane database, Essential Evidence Plus, the National Guideline Clearinghouse database, and the U.S. Preventive Services Task Force. The average length of the third stage of labor is eight to nine minutes.38, The greatest risk in the third stage is postpartum hemorrhage, which was recently redefined as 1,000 mL or more of blood loss or signs and symptoms of hypovolemia.39 The median blood loss with vaginal delivery is 574 mL.40 Blood loss is often underestimated by as much as 30%, and underestimation increases with increasing blood loss.41 The risk of hemorrhage increases after 18 minutes and is six times greater after 30 minutes.38 Postpartum hemorrhage is most commonly caused by atony (70% of cases).42 Other causes include vaginal or cervical lacerations, uterine inversion, retained products of conception, and coagulopathy.42 Table 5 lists risk factors for postpartum hemorrhage.42, Active management of the third stage of labor (AMTSL), which is recommended by the World Health Organization,43 is associated with a reduction in the risk of hemorrhage, both greater than 500 mL and greater than 1,000 mL, maternal hemoglobin level of less than 9 g per dL (90 g per L) after delivery, need for maternal blood transfusion, and need for more uterotonics in labor or in the first 24 hours after delivery.44 However, AMTSL is also associated with an increase in postpartum maternal diastolic blood pressure, emesis, and use of analgesia and a decrease in neonatal birth weight.44 Although AMTSL has traditionally consisted of oxytocin (10 IU intramuscularly or 20 IU per L intravenously at 250 mL per hour) and early cord clamping, the most important component now appears to be the administration of oxytocin.43,44 Early cord clamping is no longer a component because it does not decrease postpartum hemorrhage and may be associated with neonatal harm.35,44 Delayed cord clamping may avoid interfering with early transplacental transfusion and avoid the increase in maternal blood pressure and decrease in fetal weight associated with traditional AMTSL.44 More research is needed regarding the effects of individual components of AMTSL.44, Cervical, vaginal, and perineal lacerations should be repaired if there is bleeding. Some read more ). o [ pediatric abdominal pain ] Oxytocin can be given as 10 units IM or as an infusion of 20 units/1000 mL saline at 125 mL/hour. If you haven't had anesthesia or if the anesthesia has worn off, you'll likely receive an injection of a local anesthetic to numb the tissue. Towner D, Castro MA, Eby-Wilkens E, et al: Effect of mode of delivery in nulliparous women on neonatal intracranial injury. Some obstetricians routinely explore the uterus after each delivery. Obstet Gynecol Surv 38 (6):322338, 1983. Extension into the rectal sphincter or rectum is a risk with midline episiotomy, but if recognized promptly, the extension can be repaired successfully and heals well. Its important to stay calm, relaxed, and positive. Actively manage the third stage of labor with oxytocin (Pitocin). Because potent and volatile inhalation drugs (eg, isoflurane) can cause marked depression in the fetus, general anesthesia is not recommended for routine delivery. Some read more ). The uterus is most commonly inverted when too much traction read more . The cord should be double-clamped and cut between the clamps, and a plastic cord clip should be applied about 2 to 3 cm distal from the cord insertion on the infant. version of breech presentation successfully converted to cephalic presentation, with normal spontaneous delivery. Tears or extensions into the rectum can usually be prevented by keeping the infants head well flexed until the occipital prominence passes under the symphysis pubis. N Engl J Med 341 (23):17091714, 1999. doi: 10.1056/NEJM199912023412301, 4. Pain management during labor includes complementary modalities and systemic opioids, epidural anesthesia, and pudendal block. Paracervical block is rarely appropriate for delivery because incidence of fetal bradycardia is > 10% (1 Anesthesia reference Many obstetric units now use a combined labor, delivery, recovery, and postpartum (LDRP) room, so that the woman, support person, and neonate remain in the same room throughout their stay. Lumbar epidural injection Analgesia of a local anesthetic is the most commonly used method. Contractions soften and dilate the cervix until its flexible and wide enough for the baby to exit the mothers uterus. Because potent and volatile inhalation drugs (eg, isoflurane) can cause marked depression in the fetus, general anesthesia is not recommended for routine delivery. BJOG 110 (4):424429, 2003. doi: 10.1046/j.1471-0528.2003.02173.x, 3. Identical twins are the same in so many ways, but does that include having the same fingerprints? 6. If the placenta has not been delivered within 45 to 60 minutes of delivery, manual removal may be necessary; appropriate analgesia or anesthesia is required. Normal delivery refers to childbirth through the vagina without any medical intervention. 59320. what is the one procedure code located in the Reproductive system procedures subsection. This is the American ICD-10-CM version of O80 - other international versions of ICD-10 O80 may differ. We do not control or have responsibility for the content of any third-party site.

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