Re: Gyn: Recurrent ectopic pregnancy
From: art fougner, md (evsono@pipeline.com)
Thu May 19 16:55:56 2005
also pays to repeat LFT's
art
At Thu, 19 May 2005, Garry E. Siegel, M.D. wrote:
>
>You're correct for a hydrosalpinx, which she doesn't have.
>
>However, I advised that the tube come out due to the high (more than 50%
>per the REI) recurrence risk.
>
>Garry
>
>At Thu, 19 May 2005, R. Daniel Braun wrote:
>>
>>I think I remember that IVF success rate much better if both tube out in
>>patients with PID.
>>
>>On 5/19/05, Garry E. Siegel, M.D. <garrys@mindspring.com> wrote:
>>>
>>> 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
>>>
>>--
>>R. Daniel Braun
>>Kinky for Governor
>>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
--
art fougner, md
"If you don't know where you are going, you will wind up somewhere else."
Lawrence Peter Berra
