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Gyn: Recurrent ectopic pregnancyFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Thu May 19 14:27:22 2005
31 YO P1021 First pregnancy delivered vaginally 13 years ago, same hubby. Oligoovulatory, required Clomid to acheive an ectopic pregnancy with a peak HCG of around 4K, treated with Methotrexate in 2002. The actual involved tube was NOT identified by ultrasound. 8/2003, another ectopic, required salpingectomy due to pain. The left tube was removed, and she had adhesive disease. The right tube looked normal. Now, heading to in vitro but having logistic issues, and is pregnant. HCG 5/11, reported 5/12, 1700. 5/12 ultrasound--gestational sac in right adnexum, empty uterus. REI (phone consult) and I urge tubal removal. Patient wants glimmer of a chance of a spontaneous pregnancy, so HCG/labs done that day. HCG 2500, SGOT just a bit up at 35 (normal up to 30). Would you give methotrexate? More to follow after replies. Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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