Re: humbled by an ectopic

From: art fougner, md (evsono@pipeline.com)
Tue Feb 20 11:04:16 2001


a bit about HCG titers - once had a patient with no evidence of intrauterine pregnancy at a titer of 30,000 - a level reported to be a critical titer for seeing cardiac activity let alone pregnancy. there were no abnormal adnexal masses either. patient had had a course of perganol for ovulation induction and was adamant about not having any interventions without a clear cut diagnosis. subsequent ultrasound revealed the presence of intrauterine triplets - easily explaining the hcg titer.

art

At Mon, 19 Feb 2001, Daniel Flaherty wrote: >
>Hi,
>Anyone had an ectopic with an HCG titer of 23,000, missed on not one but two ultrasound scans? My patient tonight had IUI on Clomid back on 15 December.
>Vag probe US in January missed the ectopic, as did another one two weeks ago when her titer was 23K. Oh yeah, she had a normal 22ng/ml Progesterone level.
>
>You just can't trust lab and Xray anymore.
>
>Dan Flaherty MD
>Watertown SD

--
art fougner, md

A series of 1000 cases begins with but a single anecdote.





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