Re: You've done enough surgery when...
From: Efrain Ramirez (eramirezt@coqui.net)
Sun Feb 25 13:17:42 2007
My understanding that an US was done with 2,800.. however I admit that
it won't be a waste of time too take a second look ...
Ef
>At Sun, 25 Feb 2007, Richard Kaplan wrote:
>
>My premise was that the rise from 500 to 2800 in 3 days was greater than the
>usual doubling time and therefore there was a possibility of lab error. In
>this clinical situation I would repeat the repeat ultrasound today or
>tommorrow (26 Feb.) to confirm the absence of a normal, early IUP.
> Richard Kaplan
>
>>>----- Original Message -----
>From: "Efrain Ramirez" <eramirezt@coqui.net>
>To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
>Sent: Sunday, February 25, 2007 4:09 AM
>Subject: Re: You've done enough surgery when...
>
>> With 2,800 hCG and no GS seen?
>>
>> Ef
>>
>> -At Sun, 25 Feb 2007, Richard Kaplan wrote:
>>>
>>>It is possible that this is an IUP. The HCG value was only 500 on 2/19
>>>and
>>>maybe the second value of 2800 only 3 days later was a lab error and it is
>>>still too early to see the IUP. I suspect that by the time you read this
>>>you have either already repeated her ultrasound or have removed her
>>>"hydrosalpinx.
>>>
>>>--
>>>Richard Kaplan
>>>Greensboro, NC
>>>
>>>>>>----- Original Message -----
>>>From: "Dr Eberhard Lisse" <el@lisse.NA>
>>>To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
>>>Sent: Saturday, February 24, 2007 1:06 PM
>>>Subject: Re: You've done enough surgery when...
>>>
>>>> G4P2M0 2* previous C/S
>>>> T/L separately
>>>> Reversal of T/L
>>>> Ectopic Right tube 2007-01-17 (Appendix also removed but nil of note)
>>>>
>>>> Complains about amenorrhea since ectopic.
>>>>
>>>> Seen by by colleague in a rural hospital (90km from the capital, where I
>>>> work) 2007-02-19, b-HCG 500
>>>>
>>>> Seen by me on 2007-02-22 in the same rural setting on my monthly visit,
>>>> Clinically nil of note, a bit tender on the right side, perhaps.
>>>>
>>>> Ultrasound on the same day shows no intrauterine pregnancy, no free
>>>> fluid. Vaginal Ultrasound shows no intruterine pregnancy, right adnexa
>>>> nil of note, left adnexa, perhaps a hydrosalpingx. b-HCG 2800.
>>>>
>>>> You have a list of two total abdominal hysterectomies scheduled for the
>>>> following day in that hospital.
>>>>
>>>> So, bogs, girls and witches, what's the plan and what happened next
>>>> :-)-O?
>>>>
>>>> And, puleeze, we don't have Methrotrexate.
>>>>
>>>> greetings, el
>>>>
>> --
>> " The greatest obstacle to knowledge is not ignorance,
>> it is the illusion of knowledge." Daniel J. Boorstin - Historian
>>
--
“ The greatest obstacle to knowledge is not ignorance,
it is the illusion of knowledge.” Daniel J. Boorstin - Historian
