Re: Interstitial pregnancy
From: art fougner, md (evsono@pipeline.com)
Wed Oct 8 11:45:07 2003
Dr. Moroder
very nice mpeg ... quite diagnostic IMHO. One question about the
surgery ... why not laparoscopic treatment?
art
At Tue, 7 Oct 2003, Wolfgang Moroder, M.D. wrote:
>
>The pictures and comments on the laparotomic treatment of the
>interstitial pregnancy are ready temporarely here for vision.
>This is the appearance at opening:
>
>http://apps.obgyn.net/ultrasound/photos_action.cfm?id=320
>
>this is the repair of the uterus
>
>http://apps.obgyn.net/ultrasound/photos_action.cfm?id=321
>
>Write me for any question
>Wolfgang
>
>At Mon, 6 Oct 2003, Wolfgang Moroder, M.D. wrote:
>>
>>To see the videoclip (1.6 Megabyte) download from here:
>>
>>ftp://ftp.obgyn.net/pub/ULTRASOUND/interstiziale.m1v
>>Wolfgang
>>
>>At Mon, 6 Oct 2003, Wolfgang Moroder, M.D. wrote:
>>>
>>>Dear Terry. The videoclip is 1.6 MB. At this time it should be arrived
>>>(one never knows, once an e-mail took 4 full days to go to my next
>>>town...). Dscription of the clip: in a transvaginal coronal plane,you
>>>can see on the lefthand side of the fundus a flourishing pregnancy with
>>>an embryo of 9 weeks. In the last pictures of the clip a thin
>>>hypoechogenic endomiomitrial layer is more easily seen. The gestational
>>>sac is very eccentric. In none of the scans a connection of the chorion
>>>to the endometrial-decidual layer could be demonstrated. Although
>>>described in literature (Ackerman, Radiology 1993,189/1/83), I cannot
>>>recognize the "interstitial line sign".
>>>The patient refused treatment with methotrexate and left the hospital
>>>saying that she was leaving for Serbia. She returned on Saturday night
>>>with pain in the left lower abdomen. On Sunday night the pain worsened
>>>and on Monday mornig we decided to do a laparotomy for symptoms of
>>>haemoparitoneum. The patient had a previous laparotomy with
>>>salpingectomy for a left tubal pregnancy. On opening we found a
>>>moderate haemoperitoneum. The fundus uteri was covered with colon
>>>firmly attached to it. During accurate preparation and involuntary
>>>pressure on the fundus a 2.5 cm long fetus jumped out of the field. The
>>>thin layer of myometrium ruptured. All the chorion was accurately
>>>removed and the chorionic bed cleaned. The uterine opening was finally
>>>repaired with a continous suture.
>>>Best regards
>>>Wolfgang.
>>>
>>>At Sun, 5 Oct 2003, Terry J DuBose wrote:
>>>>
>>>>Wolfgang, I just got back to town.... How large is your MPG videoclip?
>>>>Could you email it directly to my university email... I can accept up to
>>>>about 5 megabytes there. Otherwise I think that Bruce or Kevin will
>>>>have to open a FTP site for you if it is a large file. It can be done,
>>>>but as a last resort there are CD ROMs and snail-mail.
>>>>
>>>>Thanks for being here. What can you tell us about the video?
>>>>
>>>>Peace, Terry J DuBose, M.S., RDMS
>>>>Little Rock, Arkansas USA
>>>>
>>>>On Sun, 5 Oct 2003 11:48:54 -0500 wolfgang.moroder@tin.it (Wolfgang
>>>>Moroder, MD) writes:
>>>>> To my experience (I am practicing OB-GYN in a major hospital since
>>>>> 30
>>>>> years) interstitial pregnancy is not as common as described in
>>>>> literature: 2-4% of all ectopic pregnancies. I'd like to submit a
>>>>> case
>>>>> in form of a short videoclip of a suspected interstitial pregnancy
>>>>> at 9
>>>>> weeks in order to collect some comments from the audience of this
>>>>> forum.
>>>>> Please let me know how I can post the clip which is in a MPG
>>>>> format.
>>>>> Best regards Wolfgang
>>>>>
>>>>> --
>>>>> Wolfgang Moroder, MD
>>>>> Prenatal Unit
>>>>> Bolzano General Hospital Italy
>>>>>
>>>--
>>>Wolfgang Moroder, MD
>>>Prenatal Unit
>>>Bolzano General Hospital Italy
>>>
>>--
>>Wolfgang Moroder, MD
>>Prenatal Unit
>>Bolzano General Hospital Italy
>>
>--
>Wolfgang Moroder, MD
>Prenatal Unit
>Bolzano General Hospital Italy
>
--
art fougner, md
ich bin ein New Yorker
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