-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Echinococcal cyst in pregnancy From: Elrod, Darryl G MAJ 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL) Tue Feb 28 15:24:35 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Elrod, Darryl G MAJ 48 MDOS/SGOBO: "Re: Fundal Pressure" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Fundal Pressure" Maybe in reply to: Elrod, Darryl G MAJ 48 MDOS/SGOBO: "Echinococcal cyst in pregnancy" Next in thread: Elrod, Darryl G MAJ 48 MDOS/SGOBO: "Re: Echinococcal cyst in pregnancy" I bet they will too. In fact, I'm counting on it! Nothing like having some faith that this won't be the time that the drug causes some anomaly. Obviously, the literature won't have much more than anecdotal stories of pregnant women being treated. Glen //SIGNED// D. Glen Elrod, Maj., USAF, MC Obstetrician/Gynecologist Chief of Obstetrics 48 MDOS/SGOBO RAF Lakenheath, England Telephone DSN: 314-226-8130 Comm: +44 (0) 1638 52 8130 Notice of Confidentiality Under the Privacy Act of 1974, you must safeguard all information reflected on this e-mail and, if applicable, all attachments. Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI 37-132, AFI 33-219, and PL 93-579" This e-mail message including any attachments is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. Any questions pertaining to disclosure should be directed to the privacy officer. -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of art fougner, md Sent: Tuesday, February 28, 2006 6:51 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Echinococcal cyst in pregnancy No personal experience but I did find this: * Antiparasitic chemotherapy o The basic medical treatment is chemotherapy with benzimidazoles (eg, mebendazole, albendazole) at high doses. o According to the 1996 WHO Informal Working Group on Echinococcosis, long-term chemotherapy (for several years, possibly for life) is mandatory in inoperable patients. The decision to withdraw treatment is particularly difficult without objective and irrefutable proof of definitive cure. o Complementary chemotherapy is mandatory for at least 2 years following surgery. Careful follow-up examinations in these patients must continue for at least 10 years. In all cases of palliative operations, either surgical or ultrasonographically guided, chemotherapy is mandatory and follows the same therapeutic schedule as for patients who have not had operations. o Administer chemotherapy for at least 2 years after radical liver transplantation and for life in patients who demonstrate evidence of parasitic remnants in the liver area and/or of distant metastases outside the liver. http://www.emedicine.com/med/topic326.htm I'll bet Steve or el will be able to weigh in on clinical experience. Art At Tue, 28 Feb 2006, Elrod, Darryl G MAJ 48 MDOS/SGOBO wrote: > >Group, > >We have just had a 26 yo G2P1 at 19 wks present with diffuse abdominal >pain, vomiting, WBC count of 17K. Her workup included abdominal >ultrasound that showed a 12 cm liver cyst, c/w echinococcal cyst. CT >scan the next morning (today) showed probable rupture of this cyst with >an increased amount of free fluid. > >Because her temperature increased to 101, her WBC count increased to 19K >and the findings of the CT scan, the general surgeons decided to operate >and drain the cyst. > >At surgery, there was free fluid noted. The cyst was indeed ruptured >through a small hole. 150ml of clear fluid was removed from the cyst. >The cyst was opened and a large amount of white opaque gelatinous tissue >was removed. There were also noted some typical echinococcal cysts. > >My question for the group is more a question of management for the >remainder of the pregnancy. Treatment options appear to be mebendazole >or albendazole for 3-6 months. Both of these are listed as Category C >drugs and Reprotox shows possibly some benefit of mebendazole over >albendazole, but mostly for first trimester exposure. > >Has anyone continued drug therapy for this long or have experience at >all with treating this? > >Thanks, > >Glen > >//SIGNED// > >D. Glen Elrod, Maj., USAF, MC > >Obstetrician/Gynecologist > >Chief of Obstetrics > >48 MDOS/SGOBO > >RAF Lakenheath, England > >Telephone DSN: 314-226-8130 > > Comm: +44 (0) 1638 52 8130 > >Notice of Confidentiality >Under the Privacy Act of 1974, you must safeguard all information >reflected on this e-mail and, if applicable, all attachments. >Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI >37-132, AFI 33-219, and PL 93-579" >This e-mail message including any attachments is for the sole use of the >intended recipient(s) and may contain confidential and privileged >information. Any unauthorized review, use, disclosure or distribution is >prohibited. If you are not the intended recipient, please contact the >sender by reply e-mail and destroy all copies of the original message. >Any questions pertaining to disclosure should be directed to the privacy >officer. -- art fougner, md Support Free Speech Buy Danish! Next message: Elrod, Darryl G MAJ 48 MDOS/SGOBO: "Re: Fundal Pressure" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Fundal Pressure" Maybe in reply to: Elrod, Darryl G MAJ 48 MDOS/SGOBO: "Echinococcal cyst in pregnancy" Next in thread: Elrod, Darryl G MAJ 48 MDOS/SGOBO: "Re: Echinococcal cyst in pregnancy"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Fri May 2 04:43:46 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.