Re: Tubal Pregnancy--management
From: art fougner, md (evsono@pipeline.com)
Mon Jan 21 16:10:24 2008
Follow B-HCG. Confirm with Urinary HCG. Re-evaluate.
Art
At Mon, 21 Jan 2008, Glen Elrod wrote:
>
>What would you be looking for at laparoscopy if the ultrasound only showed an ovarian cyst? Let's say the ultrasound was completely normal in the same situation, would you still scope her? If your D&C was negative and the laparascopy was negative, then what?
>
>Glen
>
>>>----- Original Message ----
>From: Rafael Haciski <haciski@earthlink.net>
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>
>Sent: Saturday, January 19, 2008 8:15:30 AM
>Subject: Re: Tubal Pregnancy--management
>
>I would not do a frozen section and would not wait for pathology
>
>I would either give her MTX or laparoscopy - with hCG at 28oo you should be able to see the ectopic
>
>--
>Rafael Haciski MD FACOG
>Anchor Health Centers GYN
>800 Goodlette Rd #360
>239-643-8780 office
>239-571-0292 cell
>Naples, FL.
>
>On Jan 19, 2008, at 10:43 AM, Garry E. Siegel, M.D. wrote:
>
>20 YO P0, seen in ER and office as follows:
>
>1/13--acute abdominal pain requiring narcotics, got better. Exam per ER
>MD negative, HCG 1300, Hemoglobin 15, ultrasound empty uterus and 3 cm.
>cyst left side.
>
>1/15--asymptomatic except spotting, HCG 1900, Hemoglobin 15, negative
>exam by me. Ultrasound no change.
>
>1/18--HCG now 2800 from 1/17, progesterone 5.4 from 1/17, exam and
>ultrasound unchanged.
>
>Would you have made a dispostion on 1//15?
>
>If so, what?
>
>If not, now it is 1/18 and I made a dispostion.
>
>Would you:
>
>1. D and C, frozen section, and scope if negative?
>2. D and C, await pathology, give methotrexate?
>3. Give methotrexate primarily?
>
>More to discuss once replies come in. . .
>
>Garry
>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
> ____________________________________________________________________________________
>Be a better friend, newshound, and
> ____________________________________________________________________________________
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
