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Re: OB: Ectopics From: R. Daniel Braun (rd.braun@gmail.com) Tue Dec 6 10:17:21 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Anil Singhal, MD: "Re: OB: Ectopics" Previous message: Richard Chudacoff, MD: "Re: Our Legal System At Work ..." In reply to: art fougner, md: "Re: OB: Ectopics" Next in thread: Anil Singhal, MD: "Re: OB: Ectopics" No, but I believe he still looks at the lining of the uterus first. The purpose of this is to R/O the incomplete or even near complete AB. In our institution we mostly do a Menstrual Aspiration and then float he tissue in saline and look for villi under the operating microscope. About once a month it keeps us from treating an Ab with Methotrexate. Dan On 12/6/05, art fougner, md <evsono@pipeline.com> wrote: > > I don't think even Tom Stovall uses Progesterone assay anymore. > > Art > > At Mon, 5 Dec 2005, Scott Oesterling wrote: > > > >Gary, > > > >I don't routinely do the curettage. In fact, I have never done one. I > >guess i really trust my ultrasound skills. > >I do know of failures in the single dose regimen when HCG are over 2000 > >- which can be within days of non-visualization on ultrasound. If > >anything, I probably overtreat non-viable intrauterine pregnancies. > >Measuring a serum progesterone might help me refine my diagnosis. > > > >-- > >Scott Oesterling > > > >On Dec 5, 2005, at 7:46 PM, Garry E. Siegel, M.D. wrote: > > > >> When faced with a "slam-dunk" unruptured, stable ectopic, say in your > >> office, and when you're considering methotrexate, what do listers do > >> about curettage? In this very hypothetical situation, let's make the > >> HCG > >> 3000, the ultrasound totally normal with a thin, well seen endometrial > >> stripe, and the exam normal, too. > >> > >> Many would simply give methotrexate here; I've seen that the diagnosis > >> of ectopic pregnancy is wrong here up to 40%. > >> > >> If you do a curettage, can you do it in the office? What type of > >> equipment is used, and what anesthesia, if any? > >> > >> Garry > >> > >> -- > >> Garry E. Siegel, M.D. > >> Private Practice > >> Roswell, GA > >> > >Scott Oesterling > > > > -- > art fougner, md > > "I knew I was going to take the wrong train, so I left early." > Lawrence Peter Berra > -- R. Daniel Braun Kinky for Governor Next message: Anil Singhal, MD: "Re: OB: Ectopics" Previous message: Richard Chudacoff, MD: "Re: Our Legal System At Work ..." In reply to: art fougner, md: "Re: OB: Ectopics" Next in thread: Anil Singhal, MD: "Re: OB: Ectopics"

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