Re: BTL in Pregnancy
From: dr. ghel (amt104@hotmail.com)
Thu Jan 20 11:33:51 2000
Patient was opened, the uterus is enlarged, the left adnexa grossly
normal, the right ovary measures 5 cm x 4 cm with actively pinpoint
bleeding, hemoperitoneum approx. 80 to 100 cc, appendix grossly normal.
We did not do the BTL after thorough explaination to the husband. In
such a case, especially if the pregnancy is not planned, doesn't matter
if it goes to term or not, can we do a BTL if strongly desired by the
couple? Couldn't find it in the book. By the way patient was placed on
Isoxsuprine drip, presently no subjective complains and no evidence of
threatened abortion.
Can we do BTL during laparotomy with intact early gestation?
thank you very much.
At Thu, 20 Jan 2000, Braun, R. Daniel wrote:
>
>So what did you find?
>
>Dan
>
>R. Daniel Braun, MD FACOG
>Clinical Professor
>Department of Obstetrics and Gynecology
>Indiana U. School of Medicine
>Indianapolis, IN 46202
>
>OBGYN.net
>International Representative for United States
>
>Certified AllExperts Expert
>Check out my bio/ratings page!
>http://www.allexperts.com/displayExpert.asp?Expert36
>
>-----Original Message-----
>From: amt104@hotmail.com [mailto:amt104@hotmail.com]
>Sent: Thursday, January 20, 2000 7:30 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: BTL in Pregnancy
>
>Thanks for the commnet, but the patient presented as an acute abdomen.
>She was previously admitted for hypogastric pain, she was closely
>observed and was discharged asymptomatic (3 days), and she came back
>after a week with severe hypogastric pain and with bilateral adnexal
>tenderness, no vaginal bleeding.
>
>At Thu, 20 Jan 2000, Braun, R. Daniel wrote:
>>
>>The tubal shouldn't be any problem once you are there. What is forcing you
>>to get there? You didn't say anything about hemodynamic instability just
>>pain and a small amount of fluid in cul-de-sac. I think I would observe
>>closely.
>>
>>Dan
>>
>>R. Daniel Braun, MD FACOG
>>Clinical Professor
>>Department of Obstetrics and Gynecology
>>Indiana U. School of Medicine
>>Indianapolis, IN 46202
>>
>>OBGYN.net
>>International Representative for United States
>>
>>Certified AllExperts Expert
>>Check out my bio/ratings page!
>>http://www.allexperts.com/displayExpert.asp?Expert36
>>
>>-----Original Message-----
>>From: amt104@hotmail.com [mailto:amt104@hotmail.com]
>>Sent: Thursday, January 20, 2000 5:18 AM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: BTL in Pregnancy
>>
>>A 38 y/o G5P4(4004) at 8 wks AOG admiited for hypogastric pain.
>>Transvaginal ultrasound reveals an intact intrauterine pergnancy, cystic
>>right ovary, minimal cul de sac fluid.
>>
>>Patient is for explor lap, to consider bleeding corpus luteum cyst,
>>requested sterilization, doesn't matter for her if she aborts or not.
>>
>>In this kind of situation, can bilateral tubal ligation be done, knowing
>>all the effects of pregnancy to the pelvic organs?
>>
>>Your expert opinions please.
>>
>>thank you.
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