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Re: A case of cervical pregnancy From: rbraun@indyunix.iupui.edu Thu May 1 16:15:02 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Roberta Speyer: "Re: Medline" Previous message: Malcolm Griffiths: "Shoulder dystocia ( was episiotomy and shoulder dystocia )" -- @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ R. Daniel Braun, MD FACOG "Money will buy you a fine dog Clinical Professor OB/GYN but only love will make it Indiana University School of Medicine wag its tail" Indianapolis, IN Richard "Kinky" OBGYN.net, International Rep. U.S. Friedman Kinky Friedman for President @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ On Sat, 26 Apr 1997, Sing-Hung Chang wrote: > I recently heard of the following case (from a resident at another > hospital): > > Asymptomatic 27 y/o primigravida with a live 9.3 wk cervical pregnancy, was > managed with 4 doses of MTX (59 mg IM every 2 days), with leucovorin > rescue. Now, the US finds a 10.1 wk pregnancy, embryo still alive, no > chorial abnormalities. Sub beta hCG levels were initially 66273, three > days later 61599, and now 46628 mIU/ml. Pt still asymptomatic. > > Questions: > > Was this the appropriate initial management? YES What were the alternatives? NONE except severe hemorrhage and hysterectomy > What is the next step you recommend from here? MORE MTX D & C will lead to much bleeding and probably hysterectomy.> > Any comments, opinions, former experience with similar cases, would be > highly appreciated. Many years ago had a similar case. Opened abdomen, isolated uterine arterie with tapes around them, then did D & C , required packing to stop bleeding in addition to pressure on Uterines. She survived and retained her fertility.in advance. > > Sing-Hung Chang > Resident > Next message: Roberta Speyer: "Re: Medline" Previous message: Malcolm Griffiths: "Shoulder dystocia ( was episiotomy and shoulder dystocia )"

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