WOMENS-HEALTH Messages for March, 2001: Re: Doctor indifference

Re: Doctor indifference

From: D. Ashley Hill, MD (anonymous@obgyn.net)
Sat, 31 Mar 2001 18:47:50 -0600 (CST)

Messages sorted by: [ date ][ thread ][ subject ][ author ]
Next message: D. Ashley Hill, MD: "Re: Effects of taking 'the pill'"
Previous message: Sharon: "Effects of taking 'the pill'"
In reply to: Theresa: "Doctor indifference"

At Sat, 31 Mar 2001, Theresa wrote:

>1. Can slow HCG rises HCG early be normal?

In general HCG should rise about 66% every 48 hours. Doctors commonly refer "doubling" of HCG, but it's really not necessary for levels to double. I do not know of any studies where HCG levels rise very slowly but the baby still turns out normal. HCG levels are not 100% reliable, since no lab test is perfect, but I have treated hundreds of patients with miscarriages and have never seen an HCG *less than 10 weeks* that went up slowly but the baby turned out normal.

>2. Is it possible for the embryo to "slip out" with no dialation or
>cramping? (this was my dr's explanation)

It depends on the gestational age/size of the embryo. At early gestational ages (lets say less than 7 weeks) it's also possible for the body to absorb the embryo.

>
>3. How do I get my doctor to listen while I'm trying to explain my
>history and not give me the "nature's way" story?

This might be tough. Luteal phase deficiency, where the ovaries do not produce enough progesterone to sustain a pregnancy, is a controversial subject. There are no good, large studies to prove it exists, but there are some data to suggest that LPD is a possible cause of miscarriage. However, since about 90% of all first-trimester miscarriages are likely due to chromosomal problems, and since progesterone cannot treat chromosomal problems, there is at best a 5-10% chance that progesterone will help prevent a miscarriage. Furthermore, progesterone might help a chromosomally abnormal fetus "hold on" for awhile when it might have miscarried earlier, just prolonging the inevitable. Still, many of my patients will take a 5% chance, but I tell them that it is unlikely that it will be successful. Sorry to hear about your miscarriage. It might be helpful to undergo a workup since you have had two of these. If you are shown to possibly have LPD your doctor should be amenable to progesterone supplementation. Best wishes,

-- David Ashley Hill, MD Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, Florida

The above is general medical information, and should not be construed as specific treatment advice. Due to time constraints, I am unable to answer individual emails. Thank you.

Next message: D. Ashley Hill, MD: "Re: Effects of taking 'the pill'"
Previous message: Sharon: "Effects of taking 'the pill'"
In reply to: Theresa: "Doctor indifference"

Women's Insurance Checklist from Auto Insurance Quote

use when must restrict search to only the women's health forum...
Enter search keywords:
	Returns per screen: Require all keywords: