Case / question to the list: PLEASE LET ME KNOW YOUR OPNIONS
From: Brickster0@aol.com
Sun Dec 21 17:57:27 2003
Listers: I'm looking for any objective opinion for a difference of agreement
with another physician / possible lurker on the list:
33 y/o wf G5P2022 with 18mth of unexplained infertility arrives for 1st ob
visit 8.5 weeks by dates but unsure LMP. Positive home beta about a week ago per
pt. No risk factors for ectopic except unexplained infertility. Pt arrives
on a Thursday. Sono by MD on a Medison 530D (a relatively good machine)
reveals no IUP; adenexal mass by real time sono reveals adenexal mass that
sonographically is a simple cyst with a sono-dense mass which I responded "did that
mass have heart beat?". It did not. Quant returns on Friday of 2300.
I will say that in my experience, our labs in Atlanta do not match the
literature in their discrepancy zone. Thus a quant of 2300 and no gestational sac
is not unheard of. In my somewhat sue-happy state. I would like to see the pt
the next day (Friday); my associate states he would ideally see the pt 48hrs
later, but since that is a Saturday he will wait until Monday.
I don't think that is appropriate. Is there anyone out there that can
convince me I'm wrong? I have learned a great deal from the list members and I
would like some objective insight into a possibly disastrous outcome.
Please tell me your opinions; however, I can tell you the outcome. I saw the
pt the next day in the office (with a GE 730) and saw an IUP with a
gestational sac, and one week later the IUP had FHTs.
Thank you all for your insight
Brick BIlls MD
Alpharetta, GA
