Re: PMB on coumadin

From: Atkinson, Samuel M (ATKINSONS@ecu.edu)
Sun Apr 29 14:43:08 2007


Hank: I have had two patients sinilar to yours, altho a bit older that i found endo ca by biopsy. I have taught residents that a bad lesion bleeds earlier on rat poisin and that they all must be biopsied. I admit that not all have endo ca hower.. for whiw. sAm

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From: ob-gyn-l@obgyn.net on behalf of Henry Gregor

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Sent: Fri 4/27/2007 11:47 AM
To: Multiple recipients of list OB-GYN-L
Subject: PMB on coumadin

Listers

A 53 yo, LMP 4 years ago, presents with two weeks plus heavy vaginal bleeding, w/o presyncopal sx's. She is on coumadin secondary to hx of mitral valve replacement. INR is 2.3, and pt is w/o petechiae, ecchymoses, or hx of epistaxis or bleeding gums, etc.

PE is unremarkable, and a pap (neg hx abnl past ones) is pending. Sono with heterogenous endometrial stripe, at 7 mm. I am planning to do an endometrial pipelle sampling. Comments appreciated.

Thanks

Hank

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