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Re: Ashermans Syndrome; Questions From: J. Hellriegel (jhellrie@pce.net) Fri Feb 9 11:31:08 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dean Huffman: "Recertification Boards" Previous message: art fougner, md: "Re: AMA news briefs" In reply to: Rafael Haciski MD: "Re: Ashermans Syndrome; Questions" Next in thread: Myer S. Bornstein, MD, CPE, FACOG: "Re: Ashermans Syndrome; Questions" At Fri, 09 Feb 2001, Rafael Haciski MD wrote: > >This may take many resection/Premarin cycles. >You did not mention if an IUD or a Word catheter were utilized to keep the >cavity expanded, which I think is essential. -- foley cath. was used. Thanks for comments. -- > >She should have another hysteroscopy to assess the cavity, and possibly >repeat the cycle of lysing adhesions followed by high dose Premarin, etc... > >Counseling as to outcome may be difficult - no solid and exact figures >exist. But is it really going to make a difference to a patient who wants >pregnancy if miscarriage rate may be doubled (example only) or abnormal >placentation rate increased?? > >-- >Rafael Haciski, MD FACOG >Gynecology & Infertility Assoc. >Baltimore MD >http://www.ivf-md.com > >> From: jhellrie@pce.net (J. Hellriegel) >> Reply-To: ob-gyn-l@obgyn.net >> Date: Thu, 8 Feb 2001 20:00:48 -0600 >> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net> >> Subject: Ashermans Syndrome; Questions >> >> Asherman’s Syndrome >> >> I have a patient who developed Asherman’s following a delivery with >> retained products of conception and endometrittis. She was then treated >> with lysis of intrauterine adhesions via hysteroscopy and Premarin for 2 >> months. Following this, her menstrual bleeding did not return. She was >> then evaluated by a specialist in infertility who performed hysteroscopy >> and laparoscopy. Additional synechiae were lysed. Tubal patency was >> confirmed. She was again treated with Premarin for 2 months. Still she >> had no menstrual bleeding. Another hysteroscopy indicated extensive >> intrauterine synechiae. No additional treatment was performed. >> >> Some 4 years later she has developed light cyclic menstrual bleeding. >> Thinks she would like to have another baby (age 30). >> >> How would you council her concerning the risks of pregnancy? (Risk of >> ectopic, placenta accreta, etc.) >> >> Are there any tests you would perform before she tries to achieve >> pregnancy? >> >> Thanks for your thoughts and help. >> >> -- >> John Hellriegel, MD, PhD >> -- John Hellriegel, MD, PhD Next message: Dean Huffman: "Recertification Boards" Previous message: art fougner, md: "Re: AMA news briefs" In reply to: Rafael Haciski MD: "Re: Ashermans Syndrome; Questions" Next in thread: Myer S. Bornstein, MD, CPE, FACOG: "Re: Ashermans Syndrome; Questions"

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