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Re: Gyn: persistent HCG From: Garry E. Siegel, M.D. (garrys@mindspring.com) Wed Nov 15 18:57:20 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Gordon Goldman: "Re: ACOG statement" Previous message: rmodugno@aol.com: "Re: Gyn: persistent HCG" In reply to: rmodugno@aol.com: "Re: Gyn: persistent HCG" Thanks to all. Recapping: OR due to blood in the abdomen--empty uterus on scan, NO curettage done. Blood and clots in belly, no tissue report generated. Now, HCG crept up from 100 the day after surgery (was 292 preop) to 224--but it took about 10 days -14 days to do so. I really feel that this is persistent trophoblast in the tube from an "incomplete" tubal abortion. Glen, I have a number of 15% of cases with persistent HCG after salpingostomy. In this case, I did NOTHING to a normal appearing tube (except that it had a clot on the end that rinsed off). I think methrotrexate, no scan, no curettage is the way to go here. Garry At Wed, 15 Nov 2006, rmodugno@aol.com wrote: > >Agree! > >Robert Modugno MD MBA FACOG >Smoky Mountain OB/Gyn Associates >64 Eastgate Drive, Sylva, NC 28779 >828-586-7802 > >-----Original Message----- >From: agfolley@hotmail.com >To: ob-gyn-l@dns.obgyn.net >Sent: Wed, 15 Nov 2006 1:46 PM >Subject: Re: Gyn: persistent HCG > > I would like to know what the path from the uterine sampling showed.  > Secondly consider methotrexate 50,g/m2 one dose and continue to follow >the hcg levels weekly until <5. andrew  >  > >From: garrys@mindspring.com (Garry E. Siegel, M.D.)  > >Reply-To: ob-gyn-l@obgyn.net  > >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>  > >Subject: Gyn: persistent HCG  > >Date: Tue, 14 Nov 2006 18:21:24 -0600  > >  > >34 YO P2002  > >ER 10/25 with acute abdominal pain, exam c/w acute abdomen, HCG 292,  > >scan showing empty uterus and free fluid.  > >  > >Lapscope--400 ml blood, normal tubes/pelvis save a clot from the left  > >tube in the fibriated end. My diagnosis was a tubal abortion, and  > >nothing done other than evacuation.  > >  > >HCG two days later 113.  > >Next week, 95, then 96 a couple of days later.  > >Now, 2.5 weeks postop, it is 224. The exam yesterday (when blood was  > >drawn) was normal.  > >  > >What's next?  > >  > >Garry  > >  > >--  > >Garry E. Siegel, M.D.  > >Private Practice  > >Roswell, GA  >  >e=hmtagline  >  -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Gordon Goldman: "Re: ACOG statement" Previous message: rmodugno@aol.com: "Re: Gyn: persistent HCG" In reply to: rmodugno@aol.com: "Re: Gyn: persistent HCG"

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