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Re: Ectopics From: Andrew Folley (agfolley@hotmail.com) Tue Dec 6 11:06:29 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: OB: Ectopics" Previous message: Anil Singhal, MD: "Re: OB: Ectopics" In reply to: ainsron: "Re: Ectopics" Next in thread: R. Daniel Braun: "Re: Ectopics" Reply: R. Daniel Braun: "Re: Ectopics" I have used the cutoffs of 1500 for TVUS. If the HCG is above 1500 you should be seeing a gestational sac in the uterus. Keep in mind 5-10% of ectopics may have a "pseudogestational sac present. I have done endometrial curetagge in office to r/o chorionic villi and confirm the ectopic just like doing an endometrial biopsy but not a routine. Typically I would do it when I am suspicious of ectopic but HCG is low and falling or not rising as expected. Ie 700 and goes up to 800 in 48 hours. When HCG is lower than 1000-1500 I do as everyone else and repeat in 48 hours. The progesterone is still a useful tool in that <5 means not a viable preganancy and more than 25 means a good pregnancy. >From: "ainsron" <ainsron@sbcglobal.net> >Reply-To: ob-gyn-l@obgyn.net >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >Subject: RE: Ectopics >Date: Tue, 6 Dec 2005 09:50:26 -0600 > >Never done one in that circumstance > >Ronald E. Ainsworth, MD, FACOG > >-----Original Message----- >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. >Siegel, M.D. >Sent: Monday, December 05, 2005 7:47 PM >To: Multiple recipients of list OB-GYN-L >Subject: OB: Ectopics > >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 > Next message: art fougner, md: "Re: OB: Ectopics" Previous message: Anil Singhal, MD: "Re: OB: Ectopics" In reply to: ainsron: "Re: Ectopics" Next in thread: R. Daniel Braun: "Re: Ectopics" Reply: R. Daniel Braun: "Re: Ectopics"

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